CAJ | 학술논문

背景：现代影像技术、计算机辅助设计及加工、快速成型等数字化技术已使骨科进入崭新的时代，数字化、个体化、微创化、精确化和智能化是未来骨科发展的方向。 　　目的：探讨计算机辅助设计数字化个体定制钢板置入内固定修复髋臼后壁骨折伴髋脱位的临床效果。 　　方法：对16例髋臼后壁骨折伴髋脱位患者采用数字化个体定制钢板置入内固定修复。骨折根据Thompson-Epstein分型，Ⅱ型7例，Ⅲ型5例，Ⅳ型2例，Ⅴ型2例。影像学检查示髋臼关节面存在2-5 mm移位，平均3 mm。伤后至入院时间为6 h-2周，平均1.5 d。入院后行股骨髁上骨牵引，12例手法复位，3例股骨头卡压者于急诊手术中复位。所有病例4-10 d后行髋臼骨折切开复位锁定数字化钢板置入内固定治疗。 　　结果与结论：内固定后骨折复位的质量按Matta标准评定,解剖复位(移位<1 mm)15例，复位欠佳(移位2.0-3.0 mm)1例。远期髋关节功能采用dcAubigne 6分法评分，优12例，良3例，差1例。提示数字化定制个体钢板置入内固定修复髋臼后壁骨折伴髋脱位更个体化、精准化，内固定牢固，避免了术中反复塑形，可有效恢复髋臼后壁的完整性，患者可早期行功能锻炼，为髋臼后壁骨折伴髋脱位内固定提供了可供选择的内固定物。
배경：현대영상기술、계산궤보조설계급가공、쾌속성형등수자화기술이사골과진입참신적시대，수자화、개체화、미창화、정학화화지능화시미래골과발전적방향。 　　목적：탐토계산궤보조설계수자화개체정제강판치입내고정수복관구후벽골절반관탈위적림상효과。 　　방법：대16례관구후벽골절반관탈위환자채용수자화개체정제강판치입내고정수복。골절근거Thompson-Epstein분형，Ⅱ형7례，Ⅲ형5례，Ⅳ형2례，Ⅴ형2례。영상학검사시관구관절면존재2-5 mm이위，평균3 mm。상후지입원시간위6 h-2주，평균1.5 d。입원후행고골과상골견인，12례수법복위，3례고골두잡압자우급진수술중복위。소유병례4-10 d후행관구골절절개복위쇄정수자화강판치입내고정치료。 　　결과여결론：내고정후골절복위적질량안Matta표준평정,해부복위(이위<1 mm)15례，복위흠가(이위2.0-3.0 mm)1례。원기관관절공능채용dcAubigne 6분법평분，우12례，량3례，차1례。제시수자화정제개체강판치입내고정수복관구후벽골절반관탈위경개체화、정준화，내고정뢰고，피면료술중반복소형，가유효회복관구후벽적완정성，환자가조기행공능단련，위관구후벽골절반관탈위내고정제공료가공선택적내고정물。
BACKGROUND:Modern imaging technology, computer-aided design and processing, rapid prototyping technology and other digital technology have enabled a new era of orthopedic field. Digitalization, individualization, minimal invasion, precision and intel igence are the potential topics in future orthopedics. OBJECTIVE:To investigate clinical efficacy of computer-aided design of digital plate in the treatment of hip dislocations associated with posterior wal acetabular fracture. METHODS:Sixteen patients of posterior wal acetabular fractures associated with hip dislocations were repaired with customized digital plate fixation. According to Thompson-Epstein fracture type:there were 7 cases with typeⅡ, 5 cases with type Ⅲ, 2 cases with type Ⅳ, and 2 cases with type Ⅴ. Radiographic examination showed the presence of 2-5 mm displacement on the acetabular articular surface, average 3 mm. The time from the injury to hospitalization was 6 hours to 2 weeks, average 1.5 days. After admission, patients underwent femoral condyle bone traction, 12 cases achieved a reduction and three cases of femoral head entrapment were reset during surgery. At 4-10 days after admission, al patients received computer-aided design of digital plate fixation for acetabular fractures. RESULTS AND CONCLUSION:Postoperative fracture quality was assessed according to Matta standards, 15 cases had anatomical reduction (displacement<1 mm) and 1 case had poor reduction (displacement 2-3 mm). The findings indicate that, computer-aided design of digital customized plate has achieved individualized and precise outcomes, as wel as firm fixation in the treatment of hip dislocations associated with posterior wal acetabular fracture. It avoids intraoperative repeated shaping, effectively restores the integrity of posterior wal , al ows early functional exercise, and provides alternative internal fixation for hip dislocations associated with posterior wal acetabular fracture.