ABSTRACT
Objective To investigate the application of 3 D visualization (3 DV) assisted proximal femoral nail anti-rotation (PFNA) surgery in the treatment of elderly intertrochanteric fracture (ITF).Methods Totally 11 cases of elderly unstable ITF were treated with 3DV assisted PFNA fixation surgery.All these patients were examined with multi-row spiral CT volume scan,and the anatomical data of Dicom was reconstructed through M3 D software.Computer aided design (CAD) was performed based on 3 D reconstruction data,including anatomical data measurement,fracture reduction simulation,and proximal femoral head nail (PFNA) implant parameter design.And the CAD data were showed by S-3DV system during operation to guide the operation.Time of operation,intra-operative blood lose,post-operative drainage volume,hospital stay time and Harris hip score were recorded and compared to the non-3DV assisted PFNA procedure.Results In 3 DV-PFNA surgery,there was no significant difference between the preoperative planned average PFNA size and the implanted average PFNA size (P ＞ 0.05).Compared to the non-3DV-PFNA surgery,3 DV-PFNA surgery has less intra-operative blood lose and post-operative drainage volume,shorter time of preoperative traction reduction and operation (P ＜ 0.05).Harris hip function score of 3 DV-PFNA surgery was better than the conventional surgery 1 week after operation,and there was no significant difference in VAS score I month after operation.The 11 cases treated with 3DV-PFNA technology were healed well,and the rate of complications was lower than the conventional surgery.Conclusion 3DV technique can show accuracy CAD model of ITF,which may play an important role to improve efficiency and accuracy of PFNA surgery.