Comparison Of CT Combined Musculoskeletal Ultrasound Localization And Manual Localization In The Operation Of Rib Fracture

Objective:To compare the clinical results of preoperative myoskeletal ultrasound localization of fracture ends with manual localization on the basis of 3D rib CT reconstruction.To explore the potential application of rib CT 3D reconstruction technique combined with preoperative positioning of musculoskeletal ultrasound in the treatment of multiple rib fractures,and to provide clinical ideas for the minimally invasive and rapid rehabilitation of multiple rib fracture treatment.Methods:A total of 130 patients with multiple rib fractures treated with incisional internal fixation of rib fractures in the Department of Cardiothoracic Surgery,Second Affiliated Hospital of Shanxi Medical University,Taiyuan,Shanxi Province,between July 2020 and July 2021,of whom 95 were eligible,were selected for retrospective analysis of their clinical case data,and were divided into CT 3D reconstruction+ according to different methods of fracture end localization.The clinical case data were retrospectively analysed and divided into CT 3D reconstruction + ultrasound localisation group(ultrasound group,41 cases)and CT3 D reconstruction + manual localisation(control group,54 cases).The data were collected and comprehensively analysed to evaluate the clinical efficacy of CT combined with musculoskeletal ultrasound in the preoperative localisation of rib fractures.Results:1.When comparing the basic clinical data of the two groups,such as age,gender,BMI,underlying disease,injury Severity Score(ISS),whether or not the chest was opened for exploration and other surgical procedures,there were differences between the ultrasound group and the control group,none of which were statistically significant(P > 0.05);there were differences in the cause of injury and the number of fractured ribs between the two groups,none of which were statistically significant(P > 0.05).2.All patients were discharged cured after surgery.The ultrasound group had a shorter single rib surgical incision length than the control group [(2.365(2-3)cm vs 3(2.5-3.89)cm),Z=-3.408,P<0.05],There was no significant difference in operation time [131(104-172.25)min vs 165(107.75-206)min,Z=-1.838,P=0.066>0.05],and Low VAS pain score 2 days after surgery [(3.8±0.8)point vs(5.2 ± 1.4)point,t=-5.183,P<0.05] short total hospital days[(18.45 ± 6.1)d vs(23.87 ± 8.8)d,t=-3.195,P<0.05],low chest wall drainage on the day of surgery[(109.175 ± 54.59)ml vs(150.25 ± 71.66)ml,t=-2.883,P<0.05].There was a difference in positioning accuracy between the two groups [92.6% vs 71.7%,P <0.05] and the difference was statistically significant.The difference in wound healing grade was also significant(P < 0.05).Conclusion:For the treatment of patients undergoing incisional internal fixation of multiple rib fractures,the use of rib CT 3D reconstruction combined with musculoskeletal ultrasound localization is safe and reliable,and has a higher accuracy rate than CT combined with manual localization,which can shorten the length of the surgical incision,relieve patients’ postoperative pain,reduce subcutaneous drainage of the chest wall,improve patients’ incision healing grade,and shorten the hospital stay,promote early recovery and obtain a better prognosis,and has high clinical application value.