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：

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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

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2.	秦勉, 刘亚雄, 贺健康, 等.数字化设计与3-D打印技术在个性化医疗中的应用.中国修复重建外科杂志, 2014, 28(3):286-291.
3.	秦泗河. 微创骨科的发展方向.中国矫形外科杂志, 2014,22(1):92-93.
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8.	陈雁西, 邵志民. 数字化骨科临床研究平台的构建及应用. 中华骨科杂志, 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.	龚辉, 朱东波, 盛小明, 等. 股骨干骨折术后钢板断裂原因分析. 江苏医药, 2014, 40(6):723-725.
12.	李象钧, 高峰, 蔡立峰, 等. 27例四肢骨折内固定失败原因分析. 浙江中医药大学学报, 2011, 35(2):174-175.
13.	崔后春, 荆鑫, 王金光, 等. 锁定钢板断裂原因分析及再手术处理原则. 临床骨科杂志, 2013, 16(6):684-686.
14.	陈振华. 钛与钛合金. 北京:化学工业出版社, 2005:22-23.
15.	黄恺, 丁亮华, 胡新宇, 等. 计算机辅助设计数字化个体钢板内固定治疗复杂胫骨平台骨折短期临床疗效分析. 中国骨与关节损伤杂志, 2013, 28(4):324-326.
16.	任绍东, 虎群盛, 刘智, 等. 数字化接骨板的研制与应用. 中国医学创新, 2012, 9(22):75-76.
17.	骆松, 戴闽, 丁志辉, 等. 新型股骨远端前外侧入路治疗股骨远端C型骨折疗效分析. 中国修复重建外科杂志, 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.	段显亮, 程维, 孙波, 等. 3种内固定治疗股骨转子间骨折患者的疗效对比. 中国老年学杂志, 2014, 34(16):4557-4559.
21.	杨志明. 加快发展3-D打印技术、扩展修复重建外科应用领域. 中国修复重建外科杂志, 2014, 28(3):265.

1. 王满宜, 王军强.计算机辅助骨科手术在创伤骨科中的应用.中华骨科杂志, 2006, 26(10):703-706.
2. 秦勉, 刘亚雄, 贺健康, 等.数字化设计与3-D打印技术在个性化医疗中的应用.中国修复重建外科杂志, 2014, 28(3):286-291.
3. 秦泗河. 微创骨科的发展方向.中国矫形外科杂志, 2014,22(1):92-93.
4. 裴国献,张元智.数字骨科学:一门骨科学新分支的萌生.中华创伤骨科杂志, 2007,9(7):601-604.
5. 尹庆水, 章莹, 王成焘, 等. 临床数字骨科学. 北京:人民军医出版社, 2011:164-168.
6. 陈雁西, 俞光荣. 踝关节骨折的治疗策略与数字化临床路径.中华骨科杂志, 2011, 31(3):275-284.
7. 张云鹏, 任龙韬. 计算机辅助骨科手术的概况与进展. 实用骨科杂志, 2009, 15(6):427-430.
8. 陈雁西, 邵志民. 数字化骨科临床研究平台的构建及应用. 中华骨科杂志, 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. 龚辉, 朱东波, 盛小明, 等. 股骨干骨折术后钢板断裂原因分析. 江苏医药, 2014, 40(6):723-725.
12. 李象钧, 高峰, 蔡立峰, 等. 27例四肢骨折内固定失败原因分析. 浙江中医药大学学报, 2011, 35(2):174-175.
13. 崔后春, 荆鑫, 王金光, 等. 锁定钢板断裂原因分析及再手术处理原则. 临床骨科杂志, 2013, 16(6):684-686.
14. 陈振华. 钛与钛合金. 北京:化学工业出版社, 2005:22-23.
15. 黄恺, 丁亮华, 胡新宇, 等. 计算机辅助设计数字化个体钢板内固定治疗复杂胫骨平台骨折短期临床疗效分析. 中国骨与关节损伤杂志, 2013, 28(4):324-326.
16. 任绍东, 虎群盛, 刘智, 等. 数字化接骨板的研制与应用. 中国医学创新, 2012, 9(22):75-76.
17. 骆松, 戴闽, 丁志辉, 等. 新型股骨远端前外侧入路治疗股骨远端C型骨折疗效分析. 中国修复重建外科杂志, 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. 段显亮, 程维, 孙波, 等. 3种内固定治疗股骨转子间骨折患者的疗效对比. 中国老年学杂志, 2014, 34(16):4557-4559.
21. 杨志明. 加快发展3-D打印技术、扩展修复重建外科应用领域. 中国修复重建外科杂志, 2014, 28(3):265.

Chinese Journal of Reparative and Reconstructive Surgery

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

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