ABSTRACT
BACKGROUND: The anatomical structure of the pelvis is complex, and it is difficult to be fixed. Misplacement of screws can lead to severe complications. Therefore, exploring an efficient, simple, and economic individualized design of surgical staple parameters has become a key issue in the fixation of the acetabular anterior column fracture. OBJECTIVE: To design parameters on the anterior column of acetabulum fracture reconstruction plate internal fixation for preoperative design using CT scan data, and to compare with conventional steel plate fixation. METHODS: Forty patients with acetabular anterior column fracture were randomly assigned to two groups: digital design group (n=20) and conventional surgery group (n=20). The digital design group received pelvic CT scanning for data acquisition. Materialise Mimics Innovation Suite 16.0 software was used for digital simulation of anterior acetabular fracture plate fixation. The conventional surgery group received conventional steel plate fixation. Operation time, blood loss and healing time were compared between the two groups. Anatomic reduction ratio and hip function score were compared between the two groups at postoperative 16 weeks. RESULTS AND CONCLUSION: (1) Operation time, blood loss, healing time, anatomic reduction ratio and hip function score were better in the digital design group than in the conventional surgery group (P=0.00). (2) Results suggest that compared with the conventional surgery group, acetabular anterior column fractures of digital three-dimensional operation design has a good effect on reducing operation time and blood loss and elevating fixation effect, and can provide reference data for clinical diagnosis and treatment of acetabular anterior column fracture.
ABSTRACT
BACKGROUND: Acetabulum anterior column shape is complex, and closed to femoral artery, and femoral nerve. Fixed screws easily went into the acetabulum. Currently, there was less data on quantitative anatomy data of pelvic acetabulum fracture with anterior column plate internal fixation. OBJECTIVE: To compare the pelvis gender differences by analyzing digital anatomical features of normal adult acetabulum anterior column section through digital three-dimensional reconstruction and measurement. METHODS: Totally 30 normal adults (half male and half female) received pelvic CT scans, and data were obtained. Using Materialise Mimics Innovation Suite 16.0 software, the boundary of the pelvis was used as reference line for sectioning. The obturator groove, iliopubic eminence, anterior inferior iliac spine, and the anterior superior iliac spine were used as a reference mark. In 15 males and 15 females (30 sides), the corresponding boundary line from obturator groove to the anterior superior iliac spine of acetabular anterior column was sliced into 5 mm-thick sections. The tangent line was vertical to the boundary line. The tangent plane was vertical to the upper plane of the anterior column. The angle and length of each section 5, 10, 15 mm points from the boundary line to the acetabulum, and the perpendicular distance from anterior and posterior edges of the acetabulum to anterior inferior iliac spine, iliopubic eminence and the pubic tubercle. RESULTS AND CONCLUSION: (1) Acetabular anterior column from the obturator groove to the anterior superior iliac spine section was not significantly different (P > 0.05). (2) No matter in males or females, the tangent angle of the fifth layer section was minimum, and the tangent length of the sixth layer section was longest. The length and angle of the second slice at 5 mm point were not significantly different between males and females. However, above indexes in others were significantly larger in females than in males (P < 0.05). (3) Results indicated that in different fracture ranges and different fixation plate positions, the angle and length of pedicle screws are dynamic, so we only selected in accordance with above range, but cannot fix in a certain value. The design of the most accurate and effective placement angle and length should be aimed at nailing design parameters for each individual patient. The use of Mimics software can be used for three-dimensional reconstruction of CT data of adult acetabular anterior column fracture, and can measure the number of indexes, and provide a theoretical reference for the clinical diagnosis and treatment of acetabular anterior column fracture.