Computerized Virtual Surgery Planning for ORIF of Proximal Humeral Fractures

摘要

The authors evaluated the effectiveness of computerized virtual planning for open reduction and internal fixation (ORIF) of proximal humeral fractures. Between June 2011 and July 2013, a total of 46 patients with proximal humeral fractures were included in the current study. Preoperatively, fracture data were obtained via computed tomography (CT) reconstruction. Based on the dataset obtained from CT scanning, the 3-dimensional model of fractures was constructed and virtual segmentation, restoration, and internal fixation were performed. All eligible cases were treated by ORIF with locking plates. Intraoperatively, operative time, blood loss, and fluoroscope frequency were recorded. Postoperatively, the curative effect was evaluated by quality of fracture restoration reconstruction and plate position. In addition, fracture healing time and complications were recorded in the follow-up period. Average operative time was 85.6 minutes, and intraoperative blood loss ranged from 60 to 150 mL. Postoperatively, 1 patient experienced avascular necrosis, and no cases of screw penetration or screw loosening were observed. The coincidence rate of plate position was 91.3% according to height and 95.7% based on the position of the intertubercular sulcus and greater tuberosity. At the end of the follow-up period, mean shoulder function score was 83.9 (range, 58-96). Eighty-seven percent of patients had an excellent or good outcome. Computerized virtual planning facilitated ORIF and showed good results for patients with complex proximal humeral fractures. It may be a favorable option for treating fractures of the proximal humerus.