基于CT数据的数字六轴外固定器复位联合锁定外固定器固定治疗胫骨干骨折的临床效果  

Clinical application of digital six-axis external fixator reduction combined with locking external fixator based on CT data in the treatment of tibial shaft fractures

作　　者：李金凤 路玉峰 陈李泽成 乔锋 LI Jinfeng;LU Yufeng;CHEN Lizecheng;QIAO Feng(Shaanxi University of Chinese Medicine,Xianyang 712000,Shaanxi,China;Department of Integrated Traditional Chinese and Western Medicine Orthopaedics,Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]陕西中医药大学,陕西咸阳712000 [2]西安交通大学附属红会医院中西医结合骨科,西安710054

出　　处：《中华骨与关节外科杂志》2024年第12期1100-1105,共6页Chinese Journal of Bone and Joint Surgery

基　　金：陕西省重点研发计划(2023-YBSF-675)。

摘　　要：目的:分析基于CT数据的数字六轴外固定器复位联合锁定外固定器固定治疗胫骨干骨折的复位精度和固定效果。方法:回顾性分析2021年10月至2023年4月西安交通大学附属红会医院使用基于CT数据的数字六轴外固定器复位联合锁定外固定器固定治疗的52例胫骨干骨折患者的临床资料。其中男40例,女12例,年龄为16~71岁,平均(38.0±12.9)岁。AO分型A型21例,B型19例,C型12例;开放性骨折16例,闭合性骨折36例。测量术前及骨折复位后骨折冠状面位移及成角、矢状面位移及成角、轴位位移,并进行比较。使用下肢功能评分(LEFS)评估下肢功能。结果:52例患者随访时间为24~50周,平均(27.1±13.1)周。骨折复位后患者骨折冠状面位移及成角、矢状面位移及成角、轴向位移分别为0.0(0.0,1.4)mm及0.0°(0.0°,0.0°)、0.0(0.0,1.5)mm及0.0°(0.0°,1.5°)、0.3(0.0,1.9)mm,均分别低于术前的7.9(4.7,13.3)mm及3.5°(1.5°,6.8°)、4.7(2.5,8.5)mm及4.0°(1.5°,7.2°)、5.6(3.3,10.0)mm,且差异均有统计学意义(P均<0.001)。所有骨折均实现解剖学复位。骨折愈合时间为12~38周,平均(24.2±6.4)周。去除锁定外固定器3个月,LEFS为51~80分,平均(75.3±5.6)分。结论:基于CT数据的数字六轴外固定器具有良好的复位效果,而锁定外固定器固定牢靠,对患者生活影响较小,二者结合治疗胫骨干骨折具有操作简单、复位精确、固定牢靠、创伤小、恢复快的优势,符合加速康复外科理念,值得临床推广。Objective:To explore the reduction accuracy and fixation effectiveness of digital six-axis external fixator reduction and locking external fixator based on CT data in the treatment of tibial shaft fractures.Methods:A retrospective analysis was conducted on the clinical data of 52 patients with tibial shaft fractures treated with digital six-axis external fixator reduction combined with locking external fixator based on CT data at the Honghui Hospital Affiliated to Xi'an Jiaotong University from October 2021 to April 2023.Forty males and 12 females were included,with an average age of 38.0±12.9 years(range:16-71 years).According to the AO classification,there were 21 cases of type A,19 cases of type B,and 12 cases of type C.There were 16 cases of open fractures and 36 cases of closed fractures.Preoperative and postoperative fracture displacement and angulation in the coronal and sagittal planes,as well as axial displacement were measured and compared.Lower extremity function was assessed using the lower extremity functional score(LEFS).Results:Fifty-two patients were followed up for 12 to 36 months,with an average of(27.1±13.1)months.Postoperatively,displacement and angulation in the coronal and sagittal planes,and axial displacement were 0.0(0.0,1.4)mm and 0.0°(0.0°,0.0°),0.0(0.0,1.5)mm and 0.0°(0.0°,1.5°),and 0.3(0.0,1.9)mm,respectively.All of these values were significantly lower than the preoperative values of 7.9(4.7,13.3)mm and 3.5°(1.5°,6.8°),4.7(2.5,8.5)mm and 4.0°(1.5°,7.2°),and 5.6(3.3,10.0)mm,respectively(all P<0.001).All fractures achieved satisfactory reduction.The fracture healing time ranged from 12 to 38 weeks,with an average of(24.2±6.4)weeks.The LEFS ranged from 51 to 80 points,with an average of(75.3±5.6)points.Conclusions:The digital six-axis external fixator based on CT data demonstrates satisfactory reduction outcomes,.The locking external fixator provides secure fixation with minimal impact on patient's daily life.The combination of these two methods in the treatment of tibia

关 键 词：胫骨干骨折 数字六轴外固定器 计算机辅助复位 锁定外固定器 

分 类 号：R683.4[医药卫生—骨科学]