Current classifications of tibial plateau fractures include three-pillar classification, four-quadrant classification, eight-segment classification, ten-segment classification, and four-column & nine-segment classification. This article reviews the various CT classifications of tibial plateau fractures, their advantages and disadvantages and surgical approaches as well. The essence of the CT classifications is to pay more attention to the coronary fracture line, especially the posterior coronal fracture fragments. A classification which combines the four-quadrant idea of the articular surface of the tibial plateau with the four-column idea of the peripheral cortex of the tibial plateau, and is supplemented by descriptions of non-articular surface structures (intercondylar spine, tibial tubercle and fibula head), may provide a more comprehensive understanding of a specific tibial plateau fracture, but may therefore be too complicated and difficult to use clinically due to too many combinations that need matching. Key words: Tibial plateau; Fracture; Classification; CT
{"title":"CT classifications of tibial plateau fractures","authors":"Zhiyong Zhou, Zhenhai Wang, Sun-jun Hu, Shi-min Zhang","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.019","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.019","url":null,"abstract":"Current classifications of tibial plateau fractures include three-pillar classification, four-quadrant classification, eight-segment classification, ten-segment classification, and four-column & nine-segment classification. This article reviews the various CT classifications of tibial plateau fractures, their advantages and disadvantages and surgical approaches as well. The essence of the CT classifications is to pay more attention to the coronary fracture line, especially the posterior coronal fracture fragments. A classification which combines the four-quadrant idea of the articular surface of the tibial plateau with the four-column idea of the peripheral cortex of the tibial plateau, and is supplemented by descriptions of non-articular surface structures (intercondylar spine, tibial tubercle and fibula head), may provide a more comprehensive understanding of a specific tibial plateau fracture, but may therefore be too complicated and difficult to use clinically due to too many combinations that need matching. \u0000 \u0000Key words: \u0000Tibial plateau; Fracture; Classification; CT","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"180-184"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47377020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.016
Zhiyi Yu
Objective To compare the cannulated screw fixation versus high-strength suture fixation in arthroscopy of tibial intercondylar fracture. Methods A retrospective analysis was performed of the 31 patients with tibial intercondylar fracture who had been treated from February 2015 to February 2018 at Department of Orthopaedics, Beijing Renhe Hospital. They were 18 males and 13 females with an average age of 34.3 years (range, from 21 to 51 years). Arthroscopic cannulated screw fixation was conducted in 13 patients (screwing group), 5 of whom were McKeever type Ⅱ and 8 of whom McKeever type Ⅲ. Arthroscopic high-intensity suture fixation was used in 18 patients (suture group), 6 of whom were McKeever type Ⅱ and 12 of whom McKeever type Ⅲ. The 2 groups were compared postoperatively in terms of operation time, hospitalization time, fracture healing time, Lysholm knee scores and rate of secondary operation. Results The 2 groups were comparable because there were no significant differences in preoperative general data between them (P>0.05). All the patients were followed up for 12 to 44 months (mean, 24.8 months). For the screwing and suture groups, respectively, operation time was 91.6 min±7.6 min and 91.9 min±7.4 min, hospitalization time 11.5 d±2.9 d and 11.4 d±2.3 d and fracture healing time 3.3 mon±0.5 mon and 3.3 mon±0.6 mon, showing no significant differences between the 2 groups (P>0.05). By the Lysholm scores at 12 months after operation, the screwing group scored from 65 to100 points with an excellent and good rate of 92.3% (12/13), and the suture group from 60 to 100 points with an excellent and good rate of 94.4% (17/18), showing no significant difference between the 2 groups (P>0.05). Ten patients (76.9%) in the screwing group had secondary arthroscopy to remove the implants but none in the suture group did. Conclusions Both cannulated screw fixation and high-strength suture fixation can achieve satisfactory clinical results in the arthroscopy of tibial intercondylar fractures, but the latter may lead to a lower rate of secondary operation. Key words: Arthroscopy; Fracture fixation, internal; Bone nails; High strength suture; Tibial eminence fracture
{"title":"Cannulated screw fixation versus high-strength suture fixation in arthroscopy of tibial intercondylar fracture","authors":"Zhiyi Yu","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.016","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.016","url":null,"abstract":"Objective \u0000To compare the cannulated screw fixation versus high-strength suture fixation in arthroscopy of tibial intercondylar fracture. \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was performed of the 31 patients with tibial intercondylar fracture who had been treated from February 2015 to February 2018 at Department of Orthopaedics, Beijing Renhe Hospital. They were 18 males and 13 females with an average age of 34.3 years (range, from 21 to 51 years). Arthroscopic cannulated screw fixation was conducted in 13 patients (screwing group), 5 of whom were McKeever type Ⅱ and 8 of whom McKeever type Ⅲ. Arthroscopic high-intensity suture fixation was used in 18 patients (suture group), 6 of whom were McKeever type Ⅱ and 12 of whom McKeever type Ⅲ. The 2 groups were compared postoperatively in terms of operation time, hospitalization time, fracture healing time, Lysholm knee scores and rate of secondary operation. \u0000 \u0000 \u0000Results \u0000The 2 groups were comparable because there were no significant differences in preoperative general data between them (P>0.05). All the patients were followed up for 12 to 44 months (mean, 24.8 months). For the screwing and suture groups, respectively, operation time was 91.6 min±7.6 min and 91.9 min±7.4 min, hospitalization time 11.5 d±2.9 d and 11.4 d±2.3 d and fracture healing time 3.3 mon±0.5 mon and 3.3 mon±0.6 mon, showing no significant differences between the 2 groups (P>0.05). By the Lysholm scores at 12 months after operation, the screwing group scored from 65 to100 points with an excellent and good rate of 92.3% (12/13), and the suture group from 60 to 100 points with an excellent and good rate of 94.4% (17/18), showing no significant difference between the 2 groups (P>0.05). Ten patients (76.9%) in the screwing group had secondary arthroscopy to remove the implants but none in the suture group did. \u0000 \u0000 \u0000Conclusions \u0000Both cannulated screw fixation and high-strength suture fixation can achieve satisfactory clinical results in the arthroscopy of tibial intercondylar fractures, but the latter may lead to a lower rate of secondary operation. \u0000 \u0000 \u0000Key words: \u0000Arthroscopy; Fracture fixation, internal; Bone nails; High strength suture; Tibial eminence fracture","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"166-169"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46105996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.004
Zhijun Pan
{"title":"Recognition of non-infectious bone nonunion--AO＇s perspective","authors":"Zhijun Pan","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.004","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.004","url":null,"abstract":"","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"112-115"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47076476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.013
Hanbin Ouyang, Zhong Huan, Wei Bo, Chen Haicong, Zhengkang Liang, Wenhua Huang, Yang Yang
Objective To optimize the topological design of locking plate for distal radial fracture so that the internal fixation stiffness can be customized. Methods Models of both the distal radial fracture and the conventional locking plate fixation were constructed using software for three-dimensional modeling and computer-aided design. Based on the data from our previous finite element analysis, a decrease of 33.33% in axial stiffness but retention of more than 90.00% in torsional stiffness were defined as the optimization limits. The conventional plate was redesigned by way of topological optimization iterations. Finite element analysis was done to compare stiffness and interfragmentary strain (IFS) between the new optimized design and conventional design of the locking plate under both compressive and torsional loads. Results The axial stiffness of the optimized plate was 636.5 N/mm with a downgrading magnitude of 19.7% which was close to the given limit; the torsional stiffness was 634.12 Nmm/° with a downgrading magnitude of 8.8% which remained under the given limit. In the optimized design, a more significant increase was observed in axial IFS than that in shear IFS, leading to a similar effect as the stiffness regulation did. Conclusion The optimized design of locking plate for distal radial fracture can provide a reliable solution for customized regulation of the internal fixation stiffness. Key words: Radius fractures; Bone plates; Finite element analysis; Topology optimization; Biomechanics
{"title":"Topological optimization of locking plate stiffness for distal radial fracture","authors":"Hanbin Ouyang, Zhong Huan, Wei Bo, Chen Haicong, Zhengkang Liang, Wenhua Huang, Yang Yang","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.013","url":null,"abstract":"Objective \u0000To optimize the topological design of locking plate for distal radial fracture so that the internal fixation stiffness can be customized. \u0000 \u0000 \u0000Methods \u0000Models of both the distal radial fracture and the conventional locking plate fixation were constructed using software for three-dimensional modeling and computer-aided design. Based on the data from our previous finite element analysis, a decrease of 33.33% in axial stiffness but retention of more than 90.00% in torsional stiffness were defined as the optimization limits. The conventional plate was redesigned by way of topological optimization iterations. Finite element analysis was done to compare stiffness and interfragmentary strain (IFS) between the new optimized design and conventional design of the locking plate under both compressive and torsional loads. \u0000 \u0000 \u0000Results \u0000The axial stiffness of the optimized plate was 636.5 N/mm with a downgrading magnitude of 19.7% which was close to the given limit; the torsional stiffness was 634.12 Nmm/° with a downgrading magnitude of 8.8% which remained under the given limit. In the optimized design, a more significant increase was observed in axial IFS than that in shear IFS, leading to a similar effect as the stiffness regulation did. \u0000 \u0000 \u0000Conclusion \u0000The optimized design of locking plate for distal radial fracture can provide a reliable solution for customized regulation of the internal fixation stiffness. \u0000 \u0000 \u0000Key words: \u0000Radius fractures; Bone plates; Finite element analysis; Topology optimization; Biomechanics","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"152-157"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48687967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To report our experience in the prevention and control of COVID-19 in the tramatological and microsurgical wards. Methods A retrospective study was conducted of the COVID-19 infections in the 51 medical staff and patients from 31 December, 2019 to 14 February, 2020 at Department of Traumatology and Microsurgery, Zhongnan Hospital. The prevention and control measures were upgraded after 20 January, 2020 to address the serious epidemic situation, including preventive disinfection, terminal disinfection and personnel disinfection in wards, management of emergency patients, inpatients and patients suspected of COVID-19 infection, and training, management and psychological intervention of medical staff. The outcomes resulting from different prevention and control measures before and after 20 January, 2020 were compared. Results From 31 December, 2019 to 20 January, 2020, there were altogether 3 cases of definite COVID-19 infection and 2 ones of suspected COVID-19 infection at the department. One doctor, one technician and one nurse were diagnosed as definite COVID-19 infection while one nurse and one patient as suspected COVID-19 infection. The 4 medical staff members infected were cured and discharged before 14 February, 2020 but unfortunately the one patient infected died. After the prevention and control measures for COVID-19 infection had been upgraded since 20 January, 2020, 12 out of the 29 emergency patients at our wards had fever (body temperature ≥37.3℃) but none COVID-19 infection. All the 47 medical staff on duty at the department got trained and none of them was infected by COVID-19 or suffered from mental disorder. Conclusion In the epidemic of COVID-19, as our prevention and control measures for COVID-19 infection were adjusted and upgraded in response to the changing epidemic situation, they eliminated nosocomial infection scientifically and effectively and ensured life safety of the medical staff and patients at the department. Key words: COVID-19; Orthopaedics; Epidemic situation; Infection prevention and control
{"title":"Experience in prevention and control of COVID-19 in tramatological and microsurgical wards","authors":"Fan Yang, Jing Hu, Lanping Hu, Zonghuan Li, Aixi Yu, Yingying Zhang","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.011","url":null,"abstract":"Objective \u0000To report our experience in the prevention and control of COVID-19 in the tramatological and microsurgical wards. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted of the COVID-19 infections in the 51 medical staff and patients from 31 December, 2019 to 14 February, 2020 at Department of Traumatology and Microsurgery, Zhongnan Hospital. The prevention and control measures were upgraded after 20 January, 2020 to address the serious epidemic situation, including preventive disinfection, terminal disinfection and personnel disinfection in wards, management of emergency patients, inpatients and patients suspected of COVID-19 infection, and training, management and psychological intervention of medical staff. The outcomes resulting from different prevention and control measures before and after 20 January, 2020 were compared. \u0000 \u0000 \u0000Results \u0000From 31 December, 2019 to 20 January, 2020, there were altogether 3 cases of definite COVID-19 infection and 2 ones of suspected COVID-19 infection at the department. One doctor, one technician and one nurse were diagnosed as definite COVID-19 infection while one nurse and one patient as suspected COVID-19 infection. The 4 medical staff members infected were cured and discharged before 14 February, 2020 but unfortunately the one patient infected died. After the prevention and control measures for COVID-19 infection had been upgraded since 20 January, 2020, 12 out of the 29 emergency patients at our wards had fever (body temperature ≥37.3℃) but none COVID-19 infection. All the 47 medical staff on duty at the department got trained and none of them was infected by COVID-19 or suffered from mental disorder. \u0000 \u0000 \u0000Conclusion \u0000In the epidemic of COVID-19, as our prevention and control measures for COVID-19 infection were adjusted and upgraded in response to the changing epidemic situation, they eliminated nosocomial infection scientifically and effectively and ensured life safety of the medical staff and patients at the department. \u0000 \u0000 \u0000Key words: \u0000COVID-19; Orthopaedics; Epidemic situation; Infection prevention and control","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"141-145"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42434942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective To evaluate the pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap for the treatment of soft tissue defects at the contrallateral leg. Methods Between January of 2012 and January of 2016, 8 patients with soft tissue defects at the leg were treated at Department of Orthopedic Surgery, Hand and Foot Surgery Hospital of Lanzhou. They were 5 men and 3 women, aged from 19 to 50 years (mean, 35 years). All of them were treated by bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap pedicled with posterior tibial artery. The size of the defects ranged from 10 cm×9 cm to 13 cm×8 cm. The immediate coverage of the muscle flaps and vessel pedicle was repaired by a meshed split-thickness skin graft. The donor site was closed directly. The therapeutic efficacy was assessed at the final follow-up according to the criteria by Iowa for tibial fractures. Results All the skin flaps and muscle flaps survived without any vascular crisis. One case developed necrosis of small skin graft at the distal muscle flap which spontaneously healed after dressing change for 2 weeks. Their follow-up ranged from 2.5 to 4.5 years (mean, 3.8 years). A good contour was confirmed at the recipient area. By the Iowa criteria at the final follow-up, 3 cases were excellent, 4 good and one fair. Conclusion Pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap is a good treatment for soft tissue defects at the contrallateral leg which has only one major blood vessel, reducing damage to the donor site. Key words: Leg injuries; Soft tissue injuries; Surgical Flaps; Muscle flap
{"title":"Pedicled bridge transplantation for soft tissue defects at the contrallateral leg with medial leg skin flap and medial hemi-soleus muscle flap","authors":"Gong-lin Zhang, Fugui Shi, Jun Hu, Tie-jun Gong, Yong-heng Wang, Lai-xu Zhao, Jun-lin Yang, Jian-hua Zhou, Qin-yi Xue","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.015","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.015","url":null,"abstract":"Objective \u0000To evaluate the pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap for the treatment of soft tissue defects at the contrallateral leg. \u0000 \u0000 \u0000Methods \u0000Between January of 2012 and January of 2016, 8 patients with soft tissue defects at the leg were treated at Department of Orthopedic Surgery, Hand and Foot Surgery Hospital of Lanzhou. They were 5 men and 3 women, aged from 19 to 50 years (mean, 35 years). All of them were treated by bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap pedicled with posterior tibial artery. The size of the defects ranged from 10 cm×9 cm to 13 cm×8 cm. The immediate coverage of the muscle flaps and vessel pedicle was repaired by a meshed split-thickness skin graft. The donor site was closed directly. The therapeutic efficacy was assessed at the final follow-up according to the criteria by Iowa for tibial fractures. \u0000 \u0000 \u0000Results \u0000All the skin flaps and muscle flaps survived without any vascular crisis. One case developed necrosis of small skin graft at the distal muscle flap which spontaneously healed after dressing change for 2 weeks. Their follow-up ranged from 2.5 to 4.5 years (mean, 3.8 years). A good contour was confirmed at the recipient area. By the Iowa criteria at the final follow-up, 3 cases were excellent, 4 good and one fair. \u0000 \u0000 \u0000Conclusion \u0000Pedicled bridge transplantation with medial leg skin flap and medial hemi-soleus muscle flap is a good treatment for soft tissue defects at the contrallateral leg which has only one major blood vessel, reducing damage to the donor site. \u0000 \u0000 \u0000Key words: \u0000Leg injuries; Soft tissue injuries; Surgical Flaps; Muscle flap","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"162-165"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49448855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.008
Mengfei Liu, Guohui Liu, Wu Zhou, T. Xia, Faqi Cao, B. Mi, Jing Liu
{"title":"Surgery for a case of femoral fracture complicated with suspected COVID-19","authors":"Mengfei Liu, Guohui Liu, Wu Zhou, T. Xia, Faqi Cao, B. Mi, Jing Liu","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.008","url":null,"abstract":"","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"128-131"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48645914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.018
Zheng-Hao Wang, Kainan Li
CT three-dimensional reconstruction has been widely used in the diagnosis and classification of fractures. Fracture mapping based on the CT three-dimensional reconstruction can visually display the morphology of fracture lines by drawing a fracture model, showing the starting and ending points, progress and area of the fracture lines. It provides a new method for diagnosis and classification of fractures, operative plan and design of implants for fractures, statistic analyses of predominant fracture sites, and developing standardized fracture models. This review gives a brief introduction of the research progress at home and abroad in fracture mapping for scapular fracture, pilon fracture, ulnar coronoid fracture, tibial plateau fracture, radial head fracture, intertrochanteric lateral wall fracture and acetabular quadrilateral surface fracture, summarizes the likely sites in the above fracture models and clinical application of fracture mapping in fracture classification, and discusses the prospects and problems of this technique in clinical application. Key words: Image processing, computer-assisted; Diagnostic imaging; Review; Fractures, models, maps; Fracture lines, morphology
{"title":"Progress in clinical application of fracture mapping based on CT three-dimensional reconstruction","authors":"Zheng-Hao Wang, Kainan Li","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.018","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.018","url":null,"abstract":"CT three-dimensional reconstruction has been widely used in the diagnosis and classification of fractures. Fracture mapping based on the CT three-dimensional reconstruction can visually display the morphology of fracture lines by drawing a fracture model, showing the starting and ending points, progress and area of the fracture lines. It provides a new method for diagnosis and classification of fractures, operative plan and design of implants for fractures, statistic analyses of predominant fracture sites, and developing standardized fracture models. This review gives a brief introduction of the research progress at home and abroad in fracture mapping for scapular fracture, pilon fracture, ulnar coronoid fracture, tibial plateau fracture, radial head fracture, intertrochanteric lateral wall fracture and acetabular quadrilateral surface fracture, summarizes the likely sites in the above fracture models and clinical application of fracture mapping in fracture classification, and discusses the prospects and problems of this technique in clinical application. \u0000 \u0000Key words: \u0000Image processing, computer-assisted; Diagnostic imaging; Review; Fractures, models, maps; Fracture lines, morphology","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"175-179"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48721378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-02-15DOI: 10.3760/CMA.J.ISSN.1671-7600.2020.02.012
Zhen-Kun Liu, Peng Xiao, Weijian Qiu, Y. Zeng, Xue-jian Wu, Xu Zhu, C. Meng, Jin-peng Sun, Jianqiang Li
Objective To evaluate the personalized 3D printed guide template used in the osteotomy for malunion of tibial fracture. Methods A retrospective analysis was conducted of the 30 patients who had been treated for malunion of tibial fracture at Department of Orthopaedics, The First Affiliated Hospital to Zhengzhou University from January 2010 to January 2018. Of them, 15 used a personalized 3D printed guide template in the osteotomy (3D printing group). They were 9 males and 6 females, with an age of 46.3 year±8.2 years. The fracture malunion was located in the upper and middle tibia in 11 cases, in the lower tibia in 4 cases, on the left side in 6 cases and on the right side in 9 ones. There were 8 cases of varus deformity and 7 ones of valgus deformity. Their preoperative fracture deformity angle was 24.3°±5.5°. The other 15 patients were treated with conventional surgery (conventional group). They were 10 males and 5 females, with an age of 47.1 years±6.0 years. The fracture was located in the upper and middle tibia in 12 cases, in the lower tibia in 3 cases, on the left side in 5 cases and on right side in 10 cases. There were 7 cases of varus deformity and 8 ones of valgus deformity. Their preoperative fracture deformity angle was 22.5°±5.4°. The 2 groups were compared in terms of preoperative baseline data, operation time, intraoperative blood loss and postoperative recovery of the alignment of lower limb. Results There were no significant differences in the preoperative baseline data between the 2 groups, showing comparability (P>0.05). The 3D printing group was followed up for an average of 12 months while the conventional group for an average of 10 months. The operation time for the 3D printing group was significantly shorter than that for the conventional group(102.2 min±13.0 min versus 137.9 min ±10.5 min), the intraoperative blood loss for the former significantly less than that for the latter (77.3 mL ± 39.7 mL versus 163.3 mL ± 35.2 mL), and the postoperative malunion angle in the former significantly smaller than that in the latter (1.9°±0.4° versus 3.2°±0.9°) (all P< 0.05). The last follow-ups revealed no implant failure or re-malunion but fine healing of the osteotomy sites and good recovery of the alignment of lower limb in the 2 groups. Conclusion A personalized 3D printed guide template used in the osteotomy for malunion of tibial fracture is an effective aid because it can facilitate precise osteotomy, reduce operation time and intraoperative blood loss and help correct the alignment of lower limb, leading to good short-term surgical outcomes. Key words: Tibial fracture; Fractures, ununited; Osteotomy; Malunion; 3D printing technology; 3D printing relay template
目的探讨个性化3D打印导骨模板在胫骨骨折不愈合截骨中的应用。方法回顾性分析2010年1月至2018年1月郑州大学第一附属医院骨科收治的胫骨骨折畸形愈合患者30例。其中15例采用个性化3D打印导骨模板(3D打印组)。男9例，女6例，年龄46.3岁±8.2岁。骨折不愈合发生在胫骨上中部11例，胫骨下段4例，左侧6例，右侧9例。内翻畸形8例，外翻畸形7例。术前骨折畸形角度为24.3°±5.5°。其余15例采用常规手术治疗(常规组)。男性10例，女性5例，年龄(47.1±6.0岁)。骨折位于胫骨上中部12例，胫骨下段3例，左侧5例，右侧10例。内翻畸形7例，外翻畸形8例。术前骨折畸形角度为22.5°±5.4°。比较两组术前基线资料、手术时间、术中出血量及术后下肢直线恢复情况。结果两组术前基线资料比较，差异无统计学意义(P < 0.05)。3D打印组平均随访12个月，而传统组平均随访10个月。3D打印组手术时间明显短于常规组(102.2 min±13.0 min vs 137.9 min±10.5 min)，术中出血量明显小于常规组(77.3 mL±39.7 mL vs 163.3 mL±35.2 mL)，术后畸形愈合角度明显小于常规组(1.9°±0.4°vs 3.2°±0.9°)(均P< 0.05)。最后随访结果显示，两组患者均无假体失败或再畸形愈合，截骨部位愈合良好，下肢直线恢复良好。结论个性化3D打印导骨模板用于胫骨骨折不愈合的截骨术是一种有效的辅助手段，可以实现精确截骨，减少手术时间和术中出血量，帮助纠正下肢对线，短期手术效果良好。关键词:胫骨骨折;骨折,ununited;截骨术;骨连接不正;3D打印技术;3D打印继电器模板
{"title":"3D printed guide template used in osteotomy for malunion of tibial fracture","authors":"Zhen-Kun Liu, Peng Xiao, Weijian Qiu, Y. Zeng, Xue-jian Wu, Xu Zhu, C. Meng, Jin-peng Sun, Jianqiang Li","doi":"10.3760/CMA.J.ISSN.1671-7600.2020.02.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1671-7600.2020.02.012","url":null,"abstract":"Objective To evaluate the personalized 3D printed guide template used in the osteotomy for malunion of tibial fracture. Methods A retrospective analysis was conducted of the 30 patients who had been treated for malunion of tibial fracture at Department of Orthopaedics, The First Affiliated Hospital to Zhengzhou University from January 2010 to January 2018. Of them, 15 used a personalized 3D printed guide template in the osteotomy (3D printing group). They were 9 males and 6 females, with an age of 46.3 year±8.2 years. The fracture malunion was located in the upper and middle tibia in 11 cases, in the lower tibia in 4 cases, on the left side in 6 cases and on the right side in 9 ones. There were 8 cases of varus deformity and 7 ones of valgus deformity. Their preoperative fracture deformity angle was 24.3°±5.5°. The other 15 patients were treated with conventional surgery (conventional group). They were 10 males and 5 females, with an age of 47.1 years±6.0 years. The fracture was located in the upper and middle tibia in 12 cases, in the lower tibia in 3 cases, on the left side in 5 cases and on right side in 10 cases. There were 7 cases of varus deformity and 8 ones of valgus deformity. Their preoperative fracture deformity angle was 22.5°±5.4°. The 2 groups were compared in terms of preoperative baseline data, operation time, intraoperative blood loss and postoperative recovery of the alignment of lower limb. Results There were no significant differences in the preoperative baseline data between the 2 groups, showing comparability (P>0.05). The 3D printing group was followed up for an average of 12 months while the conventional group for an average of 10 months. The operation time for the 3D printing group was significantly shorter than that for the conventional group(102.2 min±13.0 min versus 137.9 min ±10.5 min), the intraoperative blood loss for the former significantly less than that for the latter (77.3 mL ± 39.7 mL versus 163.3 mL ± 35.2 mL), and the postoperative malunion angle in the former significantly smaller than that in the latter (1.9°±0.4° versus 3.2°±0.9°) (all P< 0.05). The last follow-ups revealed no implant failure or re-malunion but fine healing of the osteotomy sites and good recovery of the alignment of lower limb in the 2 groups. Conclusion A personalized 3D printed guide template used in the osteotomy for malunion of tibial fracture is an effective aid because it can facilitate precise osteotomy, reduce operation time and intraoperative blood loss and help correct the alignment of lower limb, leading to good short-term surgical outcomes. Key words: Tibial fracture; Fractures, ununited; Osteotomy; Malunion; 3D printing technology; 3D printing relay template","PeriodicalId":10145,"journal":{"name":"Chinese Journal of Orthopaedic Trauma","volume":"22 1","pages":"146-151"},"PeriodicalIF":0.0,"publicationDate":"2020-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47161437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：