| Objective: to discuss the clinical advantages of arthroscopic combined with 3D printing technique for reduction and internal fixation of articular surface of tibial plateau fracture of type schazker III.Schazker of tibial plateau fracture is a common type of fracture of tibial plateau,fracture cause collapse of articular surface,can be combined with meniscus,cruciate ligament injury,improper treatment can cause knee joint dysfunction in different degree.The purpose of this study was to investigate the effect of arthroscopic technique and 3D printing technique on the diagnosis and treatment of tibial plateau fracture in the diagnosis and treatment of schazker type III fracture of tibial plateau.Methods: 9 cases of tibial plateau schazker III Department of orthopedics of Putian First Hospital from July 2011 to April 2016 were selected fracture patients as the research object,through the preoperative CT scanning to obtain the corresponding data,and then with the help of 3D printing technology,accurate print out the 1:1model to assist the design of internal fixation,and combined with arthroscopic techniques for the observation group(group A).In addition to select the same period take regular preoperative examination,and the knee joint anterolateral approach for open reduction and internal fixation for the treatment of 16 cases of bone cancer patients as the control group(B group),all the operations were done by the same group of physicians.After a mean follow-up of 12 to 18 months,compared with two groups of operative time,intraoperative bleeding volume,postoperative complications,tibial articular surface after reduction of the maximum step height,postoperative HSS knee function score,knee flexion range,were statistically analyzed using independent sample t test and four tables the Fisher exact probability method.Results: all the operations were performed by the same group of doctors.The average operation time in group A was 80.78 + 6.72 min,91.31 + 6.14 min B group;A group mean operative blood loss was 64.89 + 8.58 ml,87.12 + 10.67 ml B group;A group after the biggest step of tibial plateau CT scan height was 2.71 + 0.3mm,3.04 + 0.41 mm B group;A group after 12 months of follow-up after knee flexion range was 120.44 + 3,B group is 114.06 + 4.1;A group 12 months after operation HSS knee function score was 87.1 + 3.69,B group is 81.38 + 4.54;the index by independent sample t test statistical analysis,p<0.05,statistically significant differences between the groups.Postoperative complications: A group had 1 cases of postoperative leg swelling,improved after treatment,did not appear postoperative joint pain,infection,joint stiffness and other complications;group B postoperative swelling of the legs in 4 cases,joint pain in 1 cases.Statistical analysis of two groups of data by means of Fisher exact probability method of data:p<0.05,with statistical significance.Conclusion: the application of arthroscopic techniques could allow physicians to get a good view in the operation and help to determine the tibial plateau articular surface reduction,and repair of meniscus of knee joint and clean up debris in arthroscopic,reduce the occurrence of postoperative complications,postoperative knee function can get good.The application of 3D printing technology,can intuitively understand the articular surface of Schatzker type tibial plateau fracture degree of collapse and collapse,the doctors before surgery can simulate the fracture reduction and the collapse of the articular surface fracture model,to estimate the appropriate amount of bone,the tibia platform for reduction of the articular surface more smooth,reset effect better,patients can get personalized treatment,precision of the. |
PDF Full Text Request