CAJ | 학술논문

目的探讨定制钢板治疗膝、踝关节周围骨折的方法和初期疗效.方法对2011年3月至9月收治的13例膝、踝关节周围骨折患者资料进行回顾性分析,均为男性;年龄19 ～ 64岁,平均39.8岁.骨折根据AO分型:B型1例,C型12例.骨折发生部位:股骨远端1例,胫骨近端6例,胫骨远端6例.入院后骨折部位均行三维CT扫描(层厚0.7mm),数据通过Mimics 10.01软件分析,再经过计算机辅助设计软件UG NX7.0制作个性化钢板,局部消肿后行有限切开微创定制钢板内固定术.结果所有患者术后随访7～13个月,平均11.1个月;骨折愈合时间9～33周,平均12.8周.无发生骨折不愈合.膝、踝关节分别应用Neer、Baired-Jackson关节功能评分标准评定疗效:优9例,良3例,中1例,优良率达92.3％.结论术前可以利用定制钢板很好地模拟术中情况,定制钢板结合微创技术治疗膝、躁关节周围骨折可以取得肯定的初步疗效.
목적 탐토정제강판치료슬、과관절주위골절적방법화초기료효.방법 대2011년3월지9월수치적13례슬、과관절주위골절환자자료진행회고성분석,균위남성;년령19 ～ 64세,평균39.8세.골절근거AO분형:B형1례,C형12례.골절발생부위:고골원단1례,경골근단6례,경골원단6례.입원후골절부위균행삼유CT소묘(층후0.7mm),수거통과Mimics 10.01연건분석,재경과계산궤보조설계연건UG NX7.0제작개성화강판,국부소종후행유한절개미창정제강판내고정술.결과 소유환자술후수방7～13개월,평균11.1개월;골절유합시간9～33주,평균12.8주.무발생골절불유합.슬、과관절분별응용Neer、Baired-Jackson관절공능평분표준평정료효:우9례,량3례,중1례,우량솔체92.3％.결론 술전가이이용정제강판흔호지모의술중정황,정제강판결합미창기술치료슬、조관절주위골절가이취득긍정적초보료효.
Objective To explore the therapeutic effects of individualized custom plates in the treatment of fractures around the knee and ankle joints. Methods From March to September 2011,13 patients with fractures around the knee and ankle joints were treated in our department.They were all male,aged from 19 to 64 years (average,39.8 years).According to AO classification,there were one case of type B and 12 of type C.One patient had a distal femoral fracture,6 had a proximal tibial fracture and 6 had a distal tibial fracture. Three-dimensional reconstruction of the fracture was conducted by means of software Mimics 10.01 after CT scanning (0.7 mm per slice) for virtual simulation of the operation.The plates and screws were manufactured after computer-assisted design using software UG NX7.0.Minimally invasive plate osteosynthesis (MIPO) was applied after local detumescence to fixate the fractures with individualized custom plates and screws. Results The average following-up period was 11.1 months,ranging from 7 to 13 months.The average time for fracture healing was 12.8 weeks,ranging from 9 to 33 weeks.No nonunion was found during the follow-up.According to the Neer and Baired-Jackson scoring systems for the knee and ankle joints,the functional recovery was evaluated as excellent in 9 cases,good in 3 cases and fair in one case.The good to excellent rate was 92.3％. Conclusions Virtual simulation of the internal fixation can be conducted pre-operation with an individualized custom plate to ensure satisfactory effects.Individualized custom plates and MIPO may achieve positive outcomes for fractures around the knee and ankle joints.