摘要
目的探讨3D打印辅助改良前外侧双肌间隙入路复位内固定治疗累及后外侧柱胫骨平台骨折的临床疗效。方法回顾性分析2018年2月—2020年2月新疆医科大学第一附属医院骨科收治的累及后外侧柱胫骨平台骨折患者21例,男性14例,女性7例;年龄27~65岁,平均41.6岁。道路交通伤13例,高处坠落伤7例,其他伤1例。均采用术前3D打印技术辅助改良前外侧双肌间隙入路,术前根据后外侧主要骨折块的压缩、大小、方位,在直视下复位骨块并充分植骨,胫骨平台外侧锁定钢板于腓骨头上方尽量偏后放置固定后外侧骨块。采用Rasmussen放射学评分评估胫骨平台骨折复位情况;采用Rasmussen膝关节功能及Lachman试验评价膝关节功能及稳定性。结果手术时间55~95min,平均72.7min;术中出血量50~125mL,平均75.5mL。随访时间12~36个月,平均17.6个月。无严重神经、血管损伤及术区感染、膝关节活动受限等并发症发生。骨折均获骨性愈合,愈合时间10~15周,平均12.4周。术后1年随访时未见明显角度丢失及关节面的再次塌陷。术后Rasmussen放射学评分12~18分,平均16.3分,其中优15例,良6例,优良率100%。膝关节总伸屈度110°~150°,平均128.6°。末次随访时根据Rasmussen膝关节功能评分评定疗效:优13例,良8例,优良率100%。Lachman试验均为阴性。结论3D打印辅助下改良前外侧双肌间隙入路复位内固定治疗累及后外侧柱胫骨平台骨折是一种可供优先选择的方法。
Objective To explore the clinical effect of 3D printing assisted reduction and internal fixation through modified anterolateral bimuscular space approach in the treatment of tibial plateau fracture involving posterolateral column.Methods From Feb.2018 to Feb.2020,21 patients with posterolateral tibial plateau fractures who were treated in Department of Orthopaedics,The First Affiliated Hospital of Xinjiang Medical University were analyzed retrospectively.There were 14 males and 7 females,with an average of 41.6 years(range,27-65 years).There were 13 cases of road traffic injuries,7 cases of falling from height,and 1 case of other injuries.All patients were assisted by preoperative 3D printing technology to improve the anterolateral double muscle space approach.According to the compression,size and orientation of the posterolateral fracture blocks,the bone blocks were reset and fully grafted under direct vision before operation.The locking plate on the lateral tibial plateau was placed behind the fibular head to fix the posterolateral bone blocks as far as possible.Rasmussen radiological score was used to evaluate the reduction of tibial plateau fracture.Rasmussen knee joint function and Lachman test were used to evaluate the function and stability of knee joint.Results The operation time was 55-95 minutes,with an average of 72.7 minutes;the intraoperative bleeding ranged from 50 mL to 125 mL,with an average of 75.5mL.The follow-up time ranged from 12 to 36 months,with an average of 17.6 months.There was no serious nerve or blood vessel injuries,infection in operation area,limited knee joint movement or other complications.All fractures were healed,and the healing time was 10-15 weeks,with an average of 12.4 weeks.No obvious angle loss or joint surface collapse was found during 1 year follow-up.The Rasmussen radiological score was 12-18 points,with an average of 16.3 points,of which 15 cases were excellent,6 cases were good,and the excellent and good rate was 100%.The total flexion and extension of knee joint was
作者
黄晓夏
赵岩
彭聪
李彦宇
孔维奇
黄晓靖
Huang Xiaoxia;Zhao Yan;Peng Cong;Li Yanyu;Kong Weiqi;Huang Xiaojing(Department of Orthopaedics,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;The Affiliated Hospital of Putian University,Putian,Fujian 351100,China)
出处
《创伤外科杂志》
2021年第10期734-739,共6页
Journal of Traumatic Surgery
关键词
胫骨平台骨折
后外侧柱
改良前外侧入路
3D打印
tibial plateau fracture
posterolateral column
modified anterolateral bimuscular approach
3d printing
