EFFECTIVENESS OF DIGITAL CUSTOMIZED STEEL PLATE IN TREATMENT OF COMPLEX FRACTURES OF LIMBS_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

WANYongxian , ZHUONaiqiang , YANGYunkang , GEJianhua ,  LUXiaobo

Department of Orthopedics, Affiliated Hospital of Luzhou Medical College, Luzhou Sichuan, 646000, P. R. China;

Corresponding?author：

LUXiaobo, Email: luxiaobo1963@126.com

Keywords：

Digital customized plate; Internal fixation; Comminuted fracture

DOI：

10.7507/1002-1892.20150087

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To observe the effectiveness of digital customized plate in the treatment of complex limb fracture. Methods Between January 2012 and May 2013, CT raw data of complex limb fracture were used to establish the fracture three-dimensional simulation model after reduction, and a customized personalized anatomic plate was designed and used for internal fixation after open reduction in 42 cases. There were 22 males and 20 females, aged 16-53 years (average, 37.4 years). The causes of injury were traffic accident in 21 cases, falling from height in 18 cases, crush by heavy objects in 3 cases, including 26 cases of fresh closed fracture and 16 cases of open fracture (9 cases of type Ⅰ and 7 cases of type Ⅱ according to Gustilo classification). According to AO classification, there were 15 cases of humerus comminuted fracture, 4 cases of radial comminuted fracture, 8 cases of femoral comminuted fracture, and 15 cases of tibia comminuted fracture. The interval of injury and operation was 6-28 days (mean, 10 days). Results Reduction and internal fixation of fracture were successfully performed on 42 patients. The length and position of digital customized plate, direction and length of screw implant, number of screw were basically identical with preoperative design. The operation time was 35-120 minutes (mean, 70 minutes); the blood loss volume was 30-500 mL (mean, 180 mL); and X ray fluoroscopy frequency was 2-6 times (mean, 3 times). Superficial infection occurred in 2 cases, and was cured after dressing change; primary healing of incision was obtained in the other patients. Forty-two cases were followed up 6-24 months with an average of 11.5 months. The fracture healing time was 8-19 weeks (mean, 14 weeks) in 41 cases; delayed union occurred in 1 case at 44 weeks after operation. The fracture anatomical reduction was achieved in 19 cases, malunion in 3 cases, and functional reduction in the other patients. At last follow-up, no plate and screw loosening and breakage was observed. Conclusion Digital customized plate in treatment of complex fractures of limbs, especially for the multiple comminuted fracture of long bones of the limbs has the advantages of convenient operation, less trauma, fewer complications, and good effectiveness.

Citation： WANYongxian, ZHUONaiqiang, YANGYunkang, GEJianhua, LUXiaobo. EFFECTIVENESS OF DIGITAL CUSTOMIZED STEEL PLATE IN TREATMENT OF COMPLEX FRACTURES OF LIMBS. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(4): 402-405. doi: 10.7507/1002-1892.20150087 Copy

1.	王滿宜, 王軍強.計算機輔助骨科手術在創傷骨科中的應用.中華骨科雜志, 2006, 26(10):703-706.
2.	秦勉, 劉亞雄, 賀健康, 等.數字化設計與3-D打印技術在個性化醫療中的應用.中國修復重建外科雜志, 2014, 28(3):286-291.
3.	秦泗河. 微創骨科的發展方向.中國矯形外科雜志, 2014,22(1):92-93.
4.	裴國獻,張元智.數字骨科學:一門骨科學新分支的萌生.中華創傷骨科雜志, 2007,9(7):601-604.
5.	尹慶水, 章瑩, 王成燾, 等. 臨床數字骨科學. 北京:人民軍醫出版社, 2011:164-168.
6.	陳雁西, 俞光榮. 踝關節骨折的治療策略與數字化臨床路徑.中華骨科雜志, 2011, 31(3):275-284.
7.	張云鵬, 任龍韜. 計算機輔助骨科手術的概況與進展. 實用骨科雜志, 2009, 15(6):427-430.
8.	陳雁西, 邵志民. 數字化骨科臨床研究平臺的構建及應用. 中華骨科雜志, 2009, 29(11):993-999.
9.	Wirtz C, Abbassi F, Evangelopoulos DS, et al. High failure rate of trochanteric fracture osteosynthesis with proximalfemoral locking compression plate. Injury, 2013, 44(6):751-756.
10.	Glassner PJ, Tejwani NC. Failure of proximal femoral locking compression plate:a case series. J Orthop Trauma, 2011, 25(2):76-83.
11.	龔輝, 朱東波, 盛小明, 等. 股骨干骨折術后鋼板斷裂原因分析. 江蘇醫藥, 2014, 40(6):723-725.
12.	李象鈞, 高峰, 蔡立峰, 等. 27例四肢骨折內固定失敗原因分析. 浙江中醫藥大學學報, 2011, 35(2):174-175.
13.	崔后春, 荊鑫, 王金光, 等. 鎖定鋼板斷裂原因分析及再手術處理原則. 臨床骨科雜志, 2013, 16(6):684-686.
14.	陳振華. 鈦與鈦合金. 北京:化學工業出版社, 2005:22-23.
15.	黃愷, 丁亮華, 胡新宇, 等. 計算機輔助設計數字化個體鋼板內固定治療復雜脛骨平臺骨折短期臨床療效分析. 中國骨與關節損傷雜志, 2013, 28(4):324-326.
16.	任紹東, 虎群盛, 劉智, 等. 數字化接骨板的研制與應用. 中國醫學創新, 2012, 9(22):75-76.
17.	駱松, 戴閩, 丁志輝, 等. 新型股骨遠端前外側入路治療股骨遠端C型骨折療效分析. 中國修復重建外科雜志, 2014, 28(4):414-418.
18.	Sitnik AA, Beletsky AV. Minimally invasive percutaneous plate fixation of tibia fractures:results in 80 patients. Clin Orthop Relat Res, 2013, 471(9):2783-2789.
19.	Kobayashi M, Watanabe Y, Malsushita T. Early full range of shoulder and elbow motion is possible after minimally invasive plate osteosynthesis for humeral shaft fractures. J Orthop Trauma, 2010, 24(4):212-216.
20.	段顯亮, 程維, 孫波, 等. 3種內固定治療股骨轉子間骨折患者的療效對比. 中國老年學雜志, 2014, 34(16):4557-4559.
21.	楊志明. 加快發展3-D打印技術、擴展修復重建外科應用領域. 中國修復重建外科雜志, 2014, 28(3):265.

1. 王滿宜, 王軍強.計算機輔助骨科手術在創傷骨科中的應用.中華骨科雜志, 2006, 26(10):703-706.
2. 秦勉, 劉亞雄, 賀健康, 等.數字化設計與3-D打印技術在個性化醫療中的應用.中國修復重建外科雜志, 2014, 28(3):286-291.
3. 秦泗河. 微創骨科的發展方向.中國矯形外科雜志, 2014,22(1):92-93.
4. 裴國獻,張元智.數字骨科學:一門骨科學新分支的萌生.中華創傷骨科雜志, 2007,9(7):601-604.
5. 尹慶水, 章瑩, 王成燾, 等. 臨床數字骨科學. 北京:人民軍醫出版社, 2011:164-168.
6. 陳雁西, 俞光榮. 踝關節骨折的治療策略與數字化臨床路徑.中華骨科雜志, 2011, 31(3):275-284.
7. 張云鵬, 任龍韜. 計算機輔助骨科手術的概況與進展. 實用骨科雜志, 2009, 15(6):427-430.
8. 陳雁西, 邵志民. 數字化骨科臨床研究平臺的構建及應用. 中華骨科雜志, 2009, 29(11):993-999.
9. Wirtz C, Abbassi F, Evangelopoulos DS, et al. High failure rate of trochanteric fracture osteosynthesis with proximalfemoral locking compression plate. Injury, 2013, 44(6):751-756.
10. Glassner PJ, Tejwani NC. Failure of proximal femoral locking compression plate:a case series. J Orthop Trauma, 2011, 25(2):76-83.
11. 龔輝, 朱東波, 盛小明, 等. 股骨干骨折術后鋼板斷裂原因分析. 江蘇醫藥, 2014, 40(6):723-725.
12. 李象鈞, 高峰, 蔡立峰, 等. 27例四肢骨折內固定失敗原因分析. 浙江中醫藥大學學報, 2011, 35(2):174-175.
13. 崔后春, 荊鑫, 王金光, 等. 鎖定鋼板斷裂原因分析及再手術處理原則. 臨床骨科雜志, 2013, 16(6):684-686.
14. 陳振華. 鈦與鈦合金. 北京:化學工業出版社, 2005:22-23.
15. 黃愷, 丁亮華, 胡新宇, 等. 計算機輔助設計數字化個體鋼板內固定治療復雜脛骨平臺骨折短期臨床療效分析. 中國骨與關節損傷雜志, 2013, 28(4):324-326.
16. 任紹東, 虎群盛, 劉智, 等. 數字化接骨板的研制與應用. 中國醫學創新, 2012, 9(22):75-76.
17. 駱松, 戴閩, 丁志輝, 等. 新型股骨遠端前外側入路治療股骨遠端C型骨折療效分析. 中國修復重建外科雜志, 2014, 28(4):414-418.
18. Sitnik AA, Beletsky AV. Minimally invasive percutaneous plate fixation of tibia fractures:results in 80 patients. Clin Orthop Relat Res, 2013, 471(9):2783-2789.
19. Kobayashi M, Watanabe Y, Malsushita T. Early full range of shoulder and elbow motion is possible after minimally invasive plate osteosynthesis for humeral shaft fractures. J Orthop Trauma, 2010, 24(4):212-216.
20. 段顯亮, 程維, 孫波, 等. 3種內固定治療股骨轉子間骨折患者的療效對比. 中國老年學雜志, 2014, 34(16):4557-4559.
21. 楊志明. 加快發展3-D打印技術、擴展修復重建外科應用領域. 中國修復重建外科雜志, 2014, 28(3):265.

Chinese Journal of Reparative and Reconstructive Surgery

EFFECTIVENESS OF DIGITAL CUSTOMIZED STEEL PLATE IN TREATMENT OF COMPLEX FRACTURES OF LIMBS

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content