Comparative study on digital orthopedic three-dimensional visualization technology combined with image-based computer navigation and simple image-based computer navigation in percutaneous screw fixation for sacroiliac joint complex injury / 中华创伤杂志

ABSTRACT

Objective To compare the clinical effect of digital orthopedic three-dimensional visualization technology combined with image-based computer navigation and simple image-based computer navigation in percutaneous screw fixation for the treatment of sacroiliac joint complex injury. Methods A retrospective case-control analysis was conducted on 49 cases of sacroiliac complex injury from January 2015 to May 2017. There were 27 males and 22 females, with an average of 39.3 years old (range, 21-66 years). According to AO typing, there were 10 cases of type B1, 19 type B2, and 20 type C1. The duration from injury to operation ranged from 5 to 11 days (mean, 6.5 days). Based on the application of three-dimensiona digital programming, the 49 cases were assigned to Group A (n =24) which used Mimics computer assisted surgery software to simulate screw placement on the healthy side of sacroilic joint before operation and Group B (n = 25) without the simulation programming. Screw placement time, intraoperative fluoroscopy frequency, and intraoperative bleeding were compared between two groups. Fracture reduction was evaluated by modified Matta standard score, and the function of hip joint by Majeed pelvic fracture function score at the last follow-up. Fracture healing and complications were observed. Results All patients were followed up for an average of 10.4 months (range, 6-24 months). The time of sacroiliac joint screw placement [(18.4 ±3.0)min] and the intraoperative fluoroscopy frequency [(12.9 ± 3.8) times] in Group A were significantly less than those [(26.4 ±3.8) min, (19.4 ±1.5) times] in Group B (P ＜ 0.05). There were no significant differences between Group A and Group B in intraoperative bleeding [(14.1 ± 3.0) ml vs. (15.1 ± 2.2) ml](P＞0.05). According to the modified Matta reduction standard, the good and excellent rate of Group A was 92％ (22/24), and that of Group B was 92％ (23/25). At the last follow up, the Majeed pelvic function score was 96％ (23/24) in Group A and 92％ (23/25) in Group B (P ＞0.05). Bone healing was seen in all patients 4 months after operation, and no complications such as wound infection, deep venous thrombosis, or screw loosening were observed. Conclusion The digital orthopedic three-dimensiona visualization technology in preoperative planning can reduce the time of sacroiliac screw placement and the intraoperative fluoroscopy frequency. It is an effective adjuvant technique for the percutaneous screw fixation under navigation in the treatment of sacroiliac joint.