Three-dimensional reconstruction combined with minimally invasive titanium plate or lag screw in the repair of complex scapular fractures / 中国组织工程研究

ABSTRACT

BACKGROUND:Complex scapular fractures were mainly treated by implant fixation. Standard fixation approach (Judet approach) had long incision and big trauma. With the application of spiral CT and three-dimensional reconstruction, minimal y invasive incision could be designed before implant fixation, and then fixation could be finished by physicians. Thus, trauma was reduced and repair effect was elevated. OBJECTIVE:To observe the effects of the three-dimensional reconstruction design combined with titanium plate reconstruction or lag screw for treatment of scapular fractures. METHODS:From February 2007 to January 2012, 33 cases of scapular fractures were enrol ed from Department of Orthopedics, No. 1 Hospital of Qinhuangdao in China. They were scanned by three dimensional reconstruction of CT before implant fixation to identify the regions needed to be repositioned and fixed. Thus, minimal y invasive incision of implant fixation was designed. The dissection of skin, subcutaneous tissue and muscle was reduced. Reposition was performed. Titanium plate and/or lag screw were used for fixation. RESULTS AND CONCLUSION:The operation lasted for 90-130 minutes in 33 patients, with intraoperative blood loss for 300-400 mL. Fracture was total y healed, and the healing time was 2-4 months. The fol ow up lasted for 12-24 months. According to Hardegger standard, there were excellent in 17 cases, good in 12 cases, average in 3 cases and poor in 1 case, with an excellent and good rate of 88%. These results suggested that three-dimensional reconstruction design combined with minimal y invasive incision treatment for scapular fractures showed fewer traumas, can complete the satisfactory fracture reduction and implant fixation, and obtain good repair effect.