The value of computer reconstruction in the treatment of intra-articular fractures of the distal part of the humerus

Abstract

The aim of the work was to study the role of computer reconstruction and additive technologies in the planning of surgical treatment of intra-articular fractures of the distal part of the humerus in the early post-traumatic period. Materials and methods: the results of treatment of 44 patients with fractures of the distal part of the humerus aged from 22 to 65 years were studied. All patients underwent MSCT in the preoperative period. In 45.5 % (20) cases, in order to increase the effectiveness of preoperative planning, simulation osteosynthesis was performed on an individual printed model of the damaged bone. After completion of preoperative planning, all patients underwent osseous metallo-osteosynthesis in the first week after receiving the injury. In order to assess the effectiveness of the application of visualization techniques, a survey of the operating team was carried out regarding the informativeness of the conducted instrumental studies. Results. The average duration of surgical intervention among patients in the clinical group with standard preoperative planning was 105.9 ± 9.15 minutes. The average results of the survey of the surgical team after the surgical interventions in the specified clinical group were 21.2 ± 2.8 points. The average duration of surgery among patients of the second clinical group, whose preoperative planning included not only the assessment of MSCT results of the damaged segment, but also simulated osteosynthesis with the selection and application of optimal metal fixators, was 54.6 ± 7.14 minutes. The average results of the survey of the surgical team were 31.2 ± 1.7 points. Conclusions. The use of a combination of visualization technologies and 3D printing allows to reduce the time the patient spends in the operating room and increase the effectiveness of preoperative planning. Performing simulated osteosynthesis in the preoperative period allows you to develop an individual technique of repositioning bone fragments and use the optimal standard size of the cortical metal fixator with the distribution of the most favourable compression points of bone fragments.