Objective: To compare the reduction qualities of three-dimensional visible technique without fluoroscopy and two-dimensional fluoroscopy for unstable pelvic fractures during operations.
Methods: The clinical data of 40 patients with unstable pelvic fractures, who met the selection criteria in three clinical centers between June 2021 and September 2022, were retrospectively analyzed. According to the reduction methods, the patients were divided into two groups. Twenty patients in trial group were treated with unlocking closed reduction system combined with three-dimensional visible technique without fluoroscopy; 20 patients in control group with unlocking closed reduction system under two-dimensional fluoroscopy. There was no significant difference in the gender, age, injury mechanism, Tile type of fracture, Injury Severity Score (ISS), and the time between injury to operation between the two groups ( P>0.05). The qualities of fracture reduction according to the Matta criteria, operative time, intraoperative blood loss, fracture reduction time, times of fluoroscopy, and System Usability Scale (SUS) score were recorded and compared.
Results: All operations were successfully completed in both groups. According to the Matta criteria, the qualities of fracture reduction were rated as excellent in 19 patients (95%) in trial group, which was better than that in the control group (13 cases, 65%), with a significant difference ( χ 2=3.906, P=0.048). The operative time and intraoperative blood loss had no significant differences between the two groups ( P>0.05). The fracture reduction time and times of fluoroscopy were significantly less in trial group than in control group ( P<0.05), and SUS score in trial group was significantly higher in trial group than in control group ( P<0.05).
Conclusion: Compared to using unlocking closed reduction system under two-dimensional fluoroscopy, three-dimensional visible technique without fluoroscopy can significantly improve the reduction quality of unstable pelvic fractures without prolonging the operative time, and is valuable to reduce iatrogenic radiation exposure for patients and medical workers.
目的: 比较采用非透视下三维可视化技术与二维透视下不稳定型骨盆骨折复位质量差异。.
方法: 回顾分析2021年6月—2022年9月在3家医学中心采用骨盆解锁闭合复位装置治疗的40例不稳定型骨盆骨折患者临床资料，根据术中辅助复位方式不同分为试验组（ n=20）和对照组（ n=20）。试验组采用非透视下三维可视化技术辅助复位，对照组采用二维透视下复位。两组患者性别、年龄、损伤机制、骨折Tile分型、创伤严重程度（ISS）评分以及受伤至手术时间等一般资料比较，差异均无统计学意义（ P>0.05）。记录并比较两组患者术后即刻骨盆骨折复位质量（根据Matta复位标准进行评估）、手术时间、术中出血量、骨折复位时间、术中透视次数和系统可用性量表（SUS）评分差异。.
结果: 两组均顺利完成手术。术后即刻影像学检查示试验组骨折复位质量达优19例（95%），高于对照组13例（65%），差异有统计学意义（ χ 2=3.906， P=0.048）。两组手术时间和术中出血量比较，差异均无统计学意义（ P>0.05）；试验组骨折复位时间、术中透视次数低于对照组，SUS评分高于对照组，差异均有统计学意义（ P<0.05）。.
结论: 与二维透视相比，非透视下三维可视化技术辅助骨盆解锁闭合复位装置治疗不稳定型骨盆骨折，可在不延长手术时间情况下显著提高不稳定型骨盆骨折复位质量，对于减少患者及医疗工作者的医源性放射损伤具有一定价值。.
Keywords: Pelvic fracture; closed reduction; three-dimensional visible technique; unstable fracture.