Comparative study on digital orthopedic three-dimensional visualization technology combined with image-based computer navigation and simple image-based computer navigation for percutaneous screw fixation of acetabulum anterior column fractures

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 for percutaneous screw fixation of acetabulum anterior column fractures. Methods A retrospectivecase-control analysis was made on 19 cases undergone percutaneous screw fixation of acetabular anterior column fractures under image-based computer navigation from January 2015 to 2016 March. There were 12 males and 7 females, aged from 21 to 66 years (mean, 39.3 years). AO fracture classification was A3 type in 17 cases and B1 type in 2. Based on the application of three-dimensional digital programming, the cases were assigned to two groups: group A (n=9), virtual three-dimensional model was reconstructed and the virtual screw were inserted to uninjured side by software Mimics and group B (n=10), patients were only prepared for routine preoperative preparation. Time of anterior column screw insertion, intraoperative bleeding, intraoperative fluoroscopy frequency, fracture reduction and Majeed score were compared between the two groups. Results All cases were followed up for mean 8.4 months (range, 3-12 months). There were no significant differences between groups A and group B in intraoperative bleeding [(14.1±3.0)ml, (15.1±2.2)ml], good to excellent rate of reduction (89%, 80%), good to excellent rate of Majeed score (89%, 80%)(P>0.05). Time of anterior column screw insertion [(22.4±3.4)min] and intraoperative fluoroscopy frequency [(24.9±3.8)times] in group A were significantly less than those[(29.4±4.5)min, (30.5±5.8)times] in group B (P<0.05). Conclusion Digital orthopedic three-dimensional visualization technology is associated with shortened time of anterior column screw insertion and reduced intraoperative fluoroscopy frequency, indicating an effective adjuvant technique for percutaneous screw fixation of acetabulum anterior column under navigation. Key words: Acetabulum; Imaging, three-dimensional; Surgery, computer-assisted