Objective To introduce the application of computer aided technology in the treatment of pelvic malunion and observe the effect of this technique on the operation.Methods Data of 9 consecutive patients with pelvic malunion who were enrolled in our hospital from January 2009 to December 2012 were retrospectively observed.There were 4 patients who had undergone surgery with computer aided technology,including 3 men and 1 woman with an average age of 34 years (computer aided technology,CAT) group.According to the Tile classification,4 cases were all type C.There were 1 case with open pelvic fractures,2 associated with the craniocerebral injury,2 associated with the thoracic injury and 2 associated with the abdomen trauma.There were 5 patients who had undergone surgery without computer aided technology,including 3 men and 2 women with an average age of 32.6 years (conventional group).According to the Tile classification,4 cases were all type C.There were 1 case with open pelvic fractures,2 associated with the craniocerebral injury,3 associated with the thoracic injury and 1 associated with the abdomen trauma.The Majeed score,the visual analogue score (VAS),operation time,blood loss,blood transfusion,intraoperative fluoroscopy,degree of improvement in lower limb length,iatrogenic injury and the complication were all recorded respectively.Results For the CAT group,the operation time was 195-230 min,the blood loss was 800-1 6 00 ml,the blood transfusion was 6-16 U,intraoperative fluoroscopy was 6-11 times and the degree of improvement in lower limb length was 2-3 cm.The Majeed score in the final follow-up was 78-90 points,including 3 excellent cases and 1 good.The VAS after surgery was 0-4 points.For the conventional group,the operation time was 210-330 min,the blood loss was 600-4 500 ml,the blood transfusion was 6-28 U,intraoperative fluoroscopy was 7-18 times and the degree of improvement in lower limb length was 1-3 cm.The Majeed score in the final follow-up was 79-89 points,including 3 excellent cases and 2 good.The VAS after surgery was 1-4 points.Conclusion Surgeons can make full preoperative planning by the computer aided technology before the operation.This technology which reduces the operation time can make the operation more accurately,effectively and safely.%目的 探讨计算机辅助技术在骨盆畸形愈合治疗中的价值.方法 回顾性分析2009年1月至2012年12月治疗9例骨盆骨折畸形愈合患者资料,其中4例应用数字模拟手术、截骨方案设计、预手术等计算机辅助技术进行手术计划(计算机组),5例未应用计算机辅助技术(常规组).计算机组4例,男3例,女1例;平均年龄34岁;骨盆骨折Tile分型均为C型,其中1例为开放性骨盆骨折,2例伴颅脑损伤,2例伴胸部脏器损伤,2例伴腹部脏器损伤.常规组5例,男3例,女2例;平均年龄32.6岁;骨盆骨折Tile分型均为C型,其中1例为开放性骨盆骨折,2例伴颅脑损伤,3例伴胸部脏器损伤,1例伴腹部脏器损伤.观察两组Mejeed评分、VAS评分、手术时间、术中出血量、围手术期输血量、术中透视次数、双下肢长度改善程度、医原性损伤、并发症等指标.结果 计算机组手术时间195 ～ 230 min;术中出血量800～1 600 ml;围手术期输血量6～ 16 U;术中透视次数6～11次;双下肢长度改善程度2～～3 cm;末次随访Majeed评分78～ 90分,其中优3例,良1例;术后VAS评分0～4分.常规组手术时间210～ 330 min;术中出血量600～4 500 ml;围手术期输血量6～28U;术中透视次数7～18次;双下肢长度改善程度1～3 cm;末次随访Majeed评分79 ～ 89分,平均84.6分,其中优3例,良2例;术后VAS评分1～4分.结论 计算机辅助技术可在术前进行充分计划,使骨盆截骨矫形术操作更加准确有效、缩短手术时间、提高围手术期安全性.
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