Clinical Study Of Digital Technology-assisted Single Anterior Approach In The Treatment Of Acetabular Both-column Fractures

Objective: To observe the effect of digital technique-assisted single anterior surgical approach in the treatment of acetabular both-column fractures,and to explore the effectiveness and feasibility of digital-assisted single anterior surgical approach in the treatment of acetabular both-column fractures.Methods:The patients diagnosed with acetabular both-column fracture in our hospital from January 2016 to June 2020 were retrospectively analyzed and screened by inclusion and exclusion criteria.The traditional ilioinguinal approach(group A)was used as the control group(traditional operation group).The digital technology-assisted ilioinguinal approach(group B)and the digital technology-assisted lateral rectus abdominis approach(group C)were divided into two experimental groups(digital technology group,n = 15).The digital technology group underwent both-column acetabular surgery with the assistance of computer-aided three-dimensional modeling and visualization technology,computer-aided design technology,preoperative computer simulation operation and rapid prototyping of human bone.The traditional operation group was treated according to the traditional methods and the operator’s experience.The evaluation indexes included incision length,operation time,intraoperative blood loss,number of posterior column guide needle placement,number of C-arm fluoroscopic wheels during operation(one round per group of pelvic three-position radiographs),reduction quality of acetabular fractures(Matta standard)and hip joint function score(modified Merled’Aubigne and Postel scores).Results: Digital technology group in average operation time(A:B:C=184.00±25.79min:162.67±25.83min:156.00±36.95min),average incision length(A:B:C=27.87±1.81cm:23.93±4.99cm:12.07±2.25cm),average blood loss(A:B:C=1266.67±443.47ml:966.67±313.20ml:640.00±220.55ml),average perspective round number(A:B:C=5.33±1.29round:4.40±1.18round:3.93±1.03round),the average column screw after nailing(A:B:C=4.20±1.32time:3.20±1.32time:2.87±1.13time)is superior to traditional surgery group,in terms of auxiliary rectus lateral approach and digital technology group on the bleeding amount of incision length,smaller than digital technology aided iliac inguinal approach.There was no significant difference in Matta acetabular fracture reduction quality score(A:B:C=1.58±1.15mm:1.46±1.23mm:1.15±0.85mm)and hip joint function score(A:B:C=16.33±1.40point:16.53±1.60point:16.93±1.39point)between the digital technology group and the traditional operation group.Conclusion: Digital technology-assisted single anterior approach for the treatment of acetabular both-column fracture without posterior wall fracture is feasible and reliable,and it is more minimally invasive,accurate and faster than the traditional method,which has a certain guiding significance for the clinical treatment of acetabular both-column fracture.