2023, Vol. 27 ›› Issue (27): 4345-4350

Application of multi-slice spiral CT combined with 3D printing in the treatment of rotationally unstable pelvic fractures

Alimu·Keremu, Liang Zhilin, Pazila·Aila, Maimaitiaili·Abulikemu, Aikebaier·Tuxun   

Abstract: BACKGROUND: Pelvic fractures are a serious type of fracture, and there are limitations in the two-dimensional plane display effect of pure multi-slice spiral CT three-dimensional images, and there is a lack of preoperative planning guidance for pelvic fractures.  
OBJECTIVE: To analyze clinical effect of multi-slice spiral CT combined with 3D printing in patients with rotationally unstable pelvic fractures.
METHODS: From January 2017 to December 2020, clinical data of 90 patients with rotationally unstable pelvic fractures admitted to the First People’s Hospital of Kashgar were included. They were grouped according to the random number table method. In the study group, 47 patients underwent multi-slice spiral CT combined with 3D printing technology to guide the operation. In the control group, 43 patients used multi-slice spiral CT for preoperative guidance before open reduction and internal fixation. After 1 year of follow-up, the fracture healing time of the two groups was recorded to evaluate the quality of pelvic reduction. The pelvic function recovery results were evaluated with reference to the Majeed pelvic quantitative scoring standard. The postoperative adverse event rate in the two groups was calculated.  
RESULTS AND CONCLUSION: (1) The screw dislocation rate in the study group was lower than that in the control group (P < 0.05), and the fracture healing time was shorter than that in the control group (P < 0.05). The excellent and good rate of pelvic fracture reduction 3 months after operation was higher in the study group than that of the control group (P < 0.05). (2) Compared with 3 months after operation, the pelvic function scores of the two groups at 6 and 12 months after operation were higher (P < 0.05). There was no significant difference in pelvic function scores between the two groups at 3, 6, and 12 months after operation (P > 0.05). (3) Among the 47 cases in the study group, 1 case of fracture displacement and 2 cases of traumatic arthritis occurred, and the incidence of adverse events was 6%. Among the 43 cases in the control group, malunion occurred in 1 case, heterotopic ossification in 1 case, fracture displacement in 2 cases, traumatic arthritis in 2 cases, and pelvic instability in 2 cases, with an adverse event rate of 19%. There was no significant difference in the adverse event rate between the two groups (P > 0.05). (4) It is suggested that for rotationally unstable pelvic fractures, compared with multi-slice spiral CT alone, the use of multi-slice spiral CT combined with 3D printing technology in the guidance of the surgical plan can improve the quality of fracture reduction, shorten the fracture healing time and reduce the screw dislocation rate.

Key words: slice spiral CT, 3D printing technology, pelvic fracture, unstable pelvic fracture, internal fixation of steel plate, reduction quality, surgical index