Résumé
Objective@#To seek an accurate and objective method to locate reconstructed auricles and design frameworks with digital technology for microtia patients with craniomaxillofacial asymmetry, improving the symmetry of the postoperative ears.@*Methods@#From September 2014 to February 2016, 50 unilateral microtia patients with craniomaxillofacial asymmetry who were scheduled for auricular reconstruction were included in the study. The digital models of the patients′ ears and heads were based on the scan data preoperatively, which were collected by the three dimensional(3D) photogrammetric scanning technique. The reconstructed auricle was positioned by the mirror image of the contralateral side on the digital models. Based on the location, the morphological parameters and the corrective parameters of the autogenous cartilage frameworks could be obtained. With the guidance of the above information, ear reconstruction with tissue expander could be carried out.@*Results@#Auricular and craniofacial morphology could be reflected vividly by the digital models. Meanwhile, the location and parameters of the reconstructed ear could be acquired. And the outcomes of the 50 reconstructed ears were satisfactory with symmetrical appearance. With 1 to 8 months (average 6.8 months) of follow-up, both the doctors and the patients were satisfied with the postoperative result.@*Conclusions@#Utilizing the location and parameters which were obtained from the digital models based on 3D photogrammetric scanning is an accurate and objective way to gain more symmetrical result in clinical ear reconstruction for microtia patients with craniomaxillofacial asymmetry.
Résumé
Objective To evaluate the computer-aided design of digital plating for acetabular fracture of posterior wall associated with hip dislocation.Methods A retrospective study was conducted to analyze the 32 patients who had been admitted for acetabular fracture of posterior wall associated with hip dislocation between June 2012 and August 2016.They were 22 men and 10 women with a mean age of 42.1 years (from 21 to 57 years).They were divided according to the treatment methods into 2 groups:an observational group (n =15) subjected to digital plating and a control group (n =17) subjected to conventional plating.All the patients were treated through the Kocher-Langenbeck approach.For the patients in the observational group,patient-specific digital steel plates were manufactured after simulation of fracture reduction,design of individualized steel plate and simulation of steel plating in the computer software before operation.The 2 groups were compared in terms of operation time,intraoperative bleeding,intraoperative fluoroscopy,hospital stay,fracture reduction and hip joint function at the last follow-up and postoperative complications as well.Results For the observational group,the operation time (73.3 ± 15.2 min) was significantly shorter than that for the control group (93.2 ± 14.7 min),the intraoperative bleeding (254.3 ±63.lmL) and the intraoperative fluoroscopy (2.4 ± 0.7 times) were significantly less than those for the control group (334.6 ±70.3 mL;3.2 ±0.8 times) (P ＜ 0.05).There were no significant difference between the 2 groups in the good to excellent rate of reduction [93.3％ (14/15) versus 88.2％ (15/17)] (P ＞ 0.05).All the patients were followed up for an average of 28.1 months (from 8 to 48 months).There was no significant difference either between the 2 groups in the modified Merle d'Aubigné-Postel scores at the last follow-up (16.4 ± 1.8 versus 15.8 ± 1.6) (P ＞ 0.05).There was a significant difference between the observational and control groups in the incidence of heterotopic ossification [6.7％ (1/1) versus 17.6％ (3/17)] (P ＜0.05).Conclusions In the treatment ofacetabular fracture of posterior wall associated with hip dislocation,computer-aided design of digital plating may have advantages of shorter operation time,less intraoperative blood loss,less intraoperative fluoroscopy and lower incidence of heterotopic ossification.