【摘要】 目的探讨数字化三维重建模拟辅助手术治疗过伸性胫骨平台骨折的疗效。方法应用数字化三维重建模拟辅助手术治疗16例过伸性胫骨平台骨折患者(18膝)。术前将胫骨平台CT扫描数据导入Mimics软件进行三维重建,在数字化三维重建模型上模拟手术,术中根据术前规划行手术治疗并记录手术疗效。结果患者均获得随访,时间6～29个月。骨折均愈合,时间11～17周。胫骨平台后倾角及内翻角术后第2天、6个月、末次随访时均较术前改善(P <0.05),术后各时间段比较差异均无统计学意义(P> 0.05)。术后6个月,膝关节Rasmussen评分12～18分,HSS评分69～95分;采用HSS评分评价膝关节功能:优14膝,良3膝,可1膝,优良率为17/18。末次随访时膝关节活动度:伸直-5°～5°,屈曲120°～140°。结论数字化三维重建模拟辅助手术治疗过伸性胫骨平台骨折具有复位精准性高、手术创伤小、并发症少等优点,是一种安全、可行的治疗方法。更多还原

【Abstract】 Objective To investigate the efficacy of digital three-dimensional(3D) simulation reconstruction assisted surgery for treatment of the hyperextension tibial plateau fracture. Methods The 16 patients(18 knees) with hyperextension tibial plateau fractures were adopted with 3D simulation reconstruction assistance surgery treatment. Their CT scan data of tibial plateau fracture were imported to Mimics sofeware for 3D reconstruction. Simulation surgery was adopted on the 3D models,the intraoperative operations were guided by the preoperative operation plan,and the surgical effetct was recorded. Results All 16 patients were followed up from 6 months to 29 months. All fracture healed within 11 ～ 17 weeks. The tibial plateau posterior slope ange and the varus angle were improved at postoperative 2 d,6 months and the last follow-up,compared with the preoperation(P < 0. 05),there were no statistical differences at the various time period during postoperative follow-up(P > 0. 05). At 6 months after operation,the Rasmussen score of knee joint was 12 ～ 18 points,the Hospital for Special Surgery(HSS) of knee score was 69 ～ 95 points. HSS evaluation of the knee joint was excellent in 14 cases,good in 3,and fair in 1,with the excellent-good rate of 17/18. At the last follow-up,the knee activity range was extension with-5° ～ 5°,flextion with 120° ～ 140°. Conclusions In the treatment of the hyperextension tibial plateau fracture,the simulation reconstruction assisted surgery has the advantages of high reduction accuracy,less trauma,few complications,which is a safe and feasible method.更多还原