Multislice spiral CT navigation of screw placement after complex tibial plateau fracture

Xu Hong-wei; Wu Wei-guo

doi:10.3969/j.issn.2095-4344.2016.48.014

Abstract：BACKGROUND:At present, it lacks the ideal pedicle screws navigation method during screw placement for tibial plateau fractures. Related research showed that:multislice spiral CT reconstruction image has desired effect in navigation and positioning of pedicle screws after complex tibial plateau fractures, but has not yet been confirmed. <br> OBJECTIVE:To study the application effects of multislice spiral CT imaging in navigation and positioning of pedicle screws after complex tibial plateau fractures. <br> METHODS:Eighty cases of complex tibial plateau fractures were selected from the Fifth Affiliated Hospital of Zhengzhou University from November 2014 to December 2015. Al patients were treated with internal fixation with hol ow nail and intramedul ary nail. Al patients were randomly divided into two groups, with 40 in each group. In the X-ray group, X-ray was used for screw navigation. In the spiral CT group, multislice spiral CT was used for screw navigation. The navigation effect of multislice spiral CT was assessed by comparing the repair effects between the two groups. <br> RESULTS AND CONCLUSION:(1) In the spiral CT group, fracture site, the degree of comminution, bone fracture displacement, and impairment score were significantly higher than in the X-ray group (P<0.05). (2) Surgery time, blood loss, and postoperative drainage were significantly less in the spiral CT group than in the X-ray group (P<0.05). (3) Success rate of pedicle screws at the first time was significantly higher in the spiral CT group than in the X-ray group (P<0.05). The success rate of pedicle screws at least twice was significantly less in the spiral CT group than in the X-ray group (P<0.05). (4) Complication rate was significantly lower in the spiral CT group (8%) than in the control group (18%) (P<0.05). (5) These <br> findings suggested that spiral CT image reconstruction of complex tibial plateau fractures pedicle screw showed the desired effect, could determine the exact location and navigation of pedicle screws. The screws can be placed accurately, improve the cure rate, and promote early recovery of complex tibial plateau fracture.