Pelvic unlocking closed reduction technique combined with HoloSight system in reducing and fixating Tile C1 pelvic fractures
10.3760/cma.j.cn121113-20230413-00233
- VernacularTitle:骨盆解锁复位架联合智能可视化系统辅助复位与固定治疗Tile C1型骨盆骨折
- Author:
Li HE
1
;
Hua CHEN
;
Chengla YI
Author Information
1. 华中科技大学同济医学院附属同济医院创伤外科，武汉 430030
- Keywords:
Pelvis;
Fractures, bone;
Artificial intelligence;
External fixators
- From:
Chinese Journal of Orthopaedics
2023;43(19):1308-1315
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the effectiveness of unlocking closed reduction technique (UCRT) combined with the "Transparent Orthopaedics" intelligent visualization system (HoloSight) in reducing and fixating Tile C1 type pelvic fractures.Methods:Data of 26 patients with Tile C1 pelvic fracture treated by trauma surgery in Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from March 2019 to September 2022 were retrospectively analyzed. Among them, 13 patients were treated with the UCRT combined with the HoloSight system (HoloSight group), and 13 patients were treated with the UCRT (control group). There were 7 men and 6 women in the HoloSight group, with a mean age of 46.85±15.63 years. The pelvic fractures were classified as C1.1 in 2 cases, C1.2 in 2 cases, and C1.3 in 9 cases. The mean body mass index (BMI) was 24.08±4.15 kg/m 2. The preoperative vertical displacement was 1.80±0.76 cm and the posterior displacement was 0.80±0.63 cm. There were 9 men and 4 women in the control group, with a mean age of 38.38±13.82 years. The pelvic fractures were classified as C1.1 in 3 cases, C1.2 in 4 cases, and C1.3 in 6 cases. The mean BMI was 22.85±3.54 kg/m 2. The preoperative vertical displacement was 1.77±0.70 cm and the posterior displacement was 1.17±0.58 cm. The fracture reduction time, preoperative and postoperative fracture displacement, single screw fixation time, intraoperative reduction and fixation fluoroscopy times, visual analogue scale (VAS), Matta scoring, Majeed's score, and complications were recorded for each patient. Results:All patients were followed up for 13.65±5.06 months. The reduction time in the HoloSight group was 39.77±11.22 minutes, the single screw fixation time was 10.72±2.12 minutes, and the total fixation time was 37.15±12.12 minutes, which were significantly shorter than those in the control group, which were 67.46±16.67 minutes, 18.38±3.62 minutes, and 58.31±7.66 minutes, respectively ( t=4.97, 6.59, 5.32). The reduction and fixation fluoroscopy times were 4.38±1.33 times and 14.00±5.79 times in the HoloSight group, which were significantly less than those in the control group, which were 50.69±12.48 times and 47.77±19.34 times ( t=13.30, 6.03). The differences were statistically significant ( P<0.05). All patients' pelvic fractures healed with no significant difference ( t=0.47, P=0.644) in fracture healing time between the HoloSight group (4.92±1.66 months) and the control group (5.23±1.69 months). Postoperative Matta scoring showed that 13 patients in the HoloSight group were rated as excellent, 4 patients were rated as good, and the excellent and good rate was 100%. In the control group, 13 patients were rated as excellent and 4 patients were rated as good, with an excellent and good rate of 100%. There was no significant difference ( t=0.70, P=0.493) in preoperative VAS between the HoloSight group (6.08±1.32) and the control group (5.69±1.49). There was no significant difference ( t=1.09, P=0.286) in postoperative VAS between the HoloSight group (2.08±1.04) and the control group (2.62±1.45), and there was no significant difference in VAS improvement between the two groups ( t=1.15, P=0.262). There was no significant difference ( t=1.42, P=0.168) in Majeed's score at 6 months postoperatively between the HoloSight group (91.23±7.18) and the control group (86.38±9.98). Conclusion:HoloSight system combined with UCRT frame can effectively reduce the difficulty of fracture reduction and fixation, shorten the time of fracture reduction and fixation, and reduce the radiation to patients and doctors in the treatment of pelvic fractures.
