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-  2015 

计算机辅助术前计划在踝关节骨折手术中的应用价值

DOI: doi:10.7507/1002-1892.20150315

Keywords: 踝关节骨折, 计算机辅助软件, 术前设计, 内固定

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Abstract:

目的探讨计算机辅助术前计划在踝关节骨折手术中的应用价值。 方法2012年1月-2014年1月,收治42例踝关节骨折患者。男22例,女20例;年龄19~72岁,平均52岁。致伤原因:扭伤20例,交通事故伤14例,高处坠落伤8例。受伤至手术时间5 h~12 d,平均2.5 d。均为闭合性三踝骨折;根据Lauge-Hansen分型标准:旋后外旋型Ⅳ度25例,旋前外旋型Ⅳ度13例,旋前外展型Ⅲ度4例。行切开复位钢板螺钉内固定术前,利用Superimage虚拟手术软件行虚拟复位及内固定操作,制定手术计划。 结果手术时间为76~120 min,平均93.7 min。术后1例发生外踝切口裂开,经处理后Ⅱ期愈合;其余切口均Ⅰ期愈合。术后X线片及CT复查显示,踝关节骨折获解剖复位,内固定物位置满意。患者均获随访,随访时间9~27个月,平均14.6个月。术后6~8周患侧踝关节活动度达到或接近健侧;骨折愈合时间为11~17周,平均13.1周。末次随访时,X线片示3例(7.1%)踝关节有退行性改变;根据Baird-Jackson踝关节评分系统评定,获优24例,良13例,可5例,优良率88%。 结论计算机辅助术前设计有利于术前明确骨折类型及完善手术方案,能指导骨折复位、内固定物的选择及植入,从而获得满意临床疗效

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