Analysis Of The Curative Effect Of Anterior Medial Approach With Prying Reduction Combined With 3D Printing Technology On Simple Fracture Of Posterolateral Tibial Plateau

Objective: This study analyzes the effect of anterior medial approach pry reduction combined with 3D printing technology in the treatment of posterior lateral tibial plateau fractures by comparing the traditional posterior median approach surgical methods,to provides new ideas for the clinical treatment of posterior lateral tibial plateau fracture.Methods:This study retrospectively included 20 cases who had been treated in our Hospital from January 2017 to January 2019 and had received "open reduction and internal fixation of the posterolateral fracture of the tibial plateau." The cases were divided into two groups.The anterior medial approach prying and resetting combined with 3D printing technology was the experimental group,and the traditional posterior midline approach was performed with open reduction and internal fixation as the control group,the both groups included ten cases respectively.The experimental group had completed CT scan and 3D reconstruction before operation,and printed the proportional fracture model through 3D printing technology,and simulated the preoperative operation according to the model;the control group had improved the routine preoperative examination.By analyzing the surgical incision length,surgical duration,intraoperative blood loss,VAS score,HSS score,internal and posterior obliquity 12 months after surgery,and using SPSS statistical software to statistically analyze the difference between the two groups,P <0.05 was considered as statistically significant.Results : All patients had completed postoperative follow-up for 12 months.After analyzing the results of the two groups,it was found that the differences among age,disease course and sex were not statistically significant(P>0.05).The average operation time of the experimental group was 91.00 ± 12.87 min,which was shorter than the control group 103.00 ± 10.33(P<0.05),the difference was statistically significant;The average intraoperative blood loss of the experimental group was120.00 ± 19.58 ml,which was significantly less than the control group 151.00 ±18.07ml(P<0.05),the difference was statistically significant;The average postoperative drainage volume of the experimental group 122.00 ± 13.98 ml,significantly less than the control group 146.00 ± 11.97ml(P<0.05),the difference was statistically significant;The surgical incision length experimental group was 9.40 ±2.72 cm,less than the control group 12.00 ± 1.63cm(P<0.05),the difference was Statistically significant;The experimental group rechecked the tibial plateau inclination angle,tibial plateau inclination angle,and knee joint mobility in the experimental group after 12 months.The experimental group was 11.00 ±1.13°,10.40 ± 0.97°,119.00 ± 5.81°,while the control group was 11.95 ± 1.48 °,10.20 ± 1.14 °,and 119.00 ± 5.76 °,respectively,there was no significant difference between the posterior inclination angle,tibial plateau inclination angle,and knee joint mobility compared with the control group;The postoperative knee joint function recovery rate(100%)in the experimental group was higher than that in the control group(80%)(P<0.05).Conclusion:1.Anterior medial approach prying reduction combined with 3D printing technology for the treatment of posterior lateral tibial plateau fractures has a shorter operation time,less intraoperative blood loss and postoperative complications than traditional posterior median approach open reduction and internal fixation.The advantages of less symptoms are more conducive to patients' postoperative recovery.2.In the surgical treatment of simple fractures of the posterolateral tibial plateau,preoperative simulation by 3D printing model is conducive to the operation of the operation.3.Anterior medial approach prying reduction combined with 3D printing technology may provide new ideas for clinical treatment of posterior lateral tibial plateau simple fractures.