2022, Vol. 26 ›› Issue (36): 5764-5769

Treatment of Schatzker type V and VI tibial plateau fractures with 3D printing preoperative planning combined with double reverse traction device

He Guowen, Hu Baijun, Gao Dawei, Chen Liang   

Abstract: BACKGROUND: In the operation of Schatzker type V and VI tibial plateau fractures, the use of double reverse traction device has solved the problems of the traditional operation, such as large trauma and poor surgical effect, and has been popularized and applied in clinic to a certain extent. 3D printing technology has advantages in assisting preoperative assessment of fracture and fracture reduction planning.
OBJECTIVE: To investigate the clinical effect of the treatment of Schatzker type V and VI tibial plateau fractures with 3D printing preoperative planning combined with double reverse traction device.
METHODS: From March 2018 to March 2020, 46 patients (25 males and 21 females, aged 19-83 years) with Schatzker type V and VI tibial plateau fractures were admitted to the Department of Orthopedics, Zhongshan Chinese Medicine Hospital. All patients were assigned to two groups. Among them, 23 cases in the observation group were treated with 3D printing preoperative planning combined with double reverse traction device, and 23 cases in the control group were treated with routine double reverse traction minimally invasive operation. The data of the two groups were compared, including the total operation time, the times of intraoperative fluoroscopy, the amount of intraoperative bleeding, and the time of fracture reduction, and the data of the clinical rehabilitation indexes, including the visual analogue scale scores of the patients before and after treatment, the degree of swelling of the affected limb and the occurrence of postoperative complications. Knee function (hospital for special surgery knee score) and motor function (Fugl-Meyer assessment) scores were compared between the two groups in 6-month follow-up.
RESULTS AND CONCLUSION: (1) The operation time, fracture reduction time, blood loss, and fluoroscopy times were less in the observation group than those in the control group (P < 0.05). (2) The postoperative visual analogue scale score, the degree of swelling, and the incidence of complications were lower in the observation group than those in the control group (P < 0.05). (3) There was no significant difference in Fugl-Meyer assessment scores and hospital for special surgery knee score knee function scores between the observation group and the control group at 3 and 6 months postoperatively (P > 0.05). (4) It is a safe and effective method to treat Schatzker type V and VI tibial plateau fractures with 3D printing preoperative planning combined with double reverse traction device. It can shorten the operation time and the fracture reduction time, reduce the blood loss, reduce the postoperative pain and swelling, and lower extremity venous thrombosis and other complications.
Key words: fracture of tibial plateau, double reverse traction device, 3D printing technology, preoperative planning, curative effect analysis