Application of three-dimensional visualization technology for digital orthopedics in the reduction and fixation of intertrochanteric fracture

doi:10.12307/2021.085

Abstract

Abstract: BACKGROUND: For complex intertrochanteric fractures, there is lack of effective preoperative planning, which lead to prolonged operation time and increased difficulty. At the same time, the application of digital orthopedics three-dimensional (3D) visualization technology in the operation of intertrochanteric fracture lacks clinical application verification.
OBJECTIVE: 3D visualization technology for digital orthopedics can be used to clarify the displacement of complex intertrochanteric fractures and realize preoperative simulated reduction and fixation, thus providing ideas and methods for intraoperative reduction and fixation of complex intertrochanteric fractures.
METHODS: Patients with complex intertrochanteric fractures (AO typing: A2 and A3) admitted to Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2019 to January 2020 were selected and randomly divided into Mimics 3D reconstruction simulation reduction group and control group according to the order of admission. According to medical procedures, all the patients were implemented with plain X-ray examination of the affected hip and CT scanning of the affected hip. Patients in the Mimics 3D reconstruction simulation reduction group achieved 3D reconstruction through Mimics 17.0 software, and then the shattered fracture blocks were simulated reduction and fixation. Patients in the control group were treated with internal fixation only according to preoperative imaging examination. Data were collected to compare the differences between the two groups in terms of operation time, intraoperative blood loss, hip reduction quality score, and hip function during follow-up.
RESULTS AND CONCLUSION: (1) The operation time was significantly shorter in the Mimics 3D reconstruction simulation reduction group than that in the control group, and intraoperative blood loss was significantly reduced in the Mimics 3D reconstruction simulation reduction group compared with the control group, and the difference between the two groups was statistically significant (P < 0.05). (2) The excellent and good rate of hip reduction quality score was significantly higher in the Mimics 3D reconstruction simulation reduction group (96%) than that in the control group (82%) (P < 0.05). (3) The hip function score was significantly higher in the Mimics 3D reconstruction simulation reduction group (95.7±5.8) points than that in the control group (82.9±10.2) points 6 months after surgery (P < 0.05). (4) The results confirmed that for complex femoral intertrochanteric fractures, preoperative 3D reconstruction simulations by Mimics software reset can help to get a comprehensive understanding of fracture displacement, detailed guide the choice of intraoperative fracture reduction and internal fixation, help to shorten the operation time, lessen intraoperative blood loss, and improve the curative effect of intertrochanteric fracture.

Key words: intertrochanteric fracture, three-dimensional visualization, simulated reduction, reduction quality, hip function, internal fixation

CLC Number:

Wang Yihan, Li Yang, Zhang Ling, Zhang Rui, Xu Ruida, Han Xiaofeng, Cheng Guangqi, Wang Weil. Application of three-dimensional visualization technology for digital orthopedics in the reduction and fixation of intertrochanteric fracture [J]. Chinese Journal of Tissue Engineering Research, 2021, 25(24): 3816-3820.

Figures/Tables 4

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