Analysis for Clinical Effect of Virtual Windowing and Poking Reduction Treatment for Schatzker III Tibial Plateau Fracture Based on 3D CT Data

Zhang, Huafeng; Li, Zhijun; Xu, Qian; Zhang, Yuan; Xu, Ke; Ma, Xinlong

doi:10.1155/2015/231820

Cited by 7 publications

(26 citation statements)

References 16 publications

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“…This technology was described in two of the included articles which also showed potential improvement in operation time, fracture reduction and patient outcome [18,25]. These studies, however, were pilot studies and, therefore, limited [24] 3D printed fracture models 34 38 85.2 ± 0.9 99.2 ± 1.0 < 0.001* Ozturk et al [27] 3D printed fracture models 10 10 89.5 ± 5.9 127 ± 14.5 < 0.05* Shen et al [29] 3D printed fracture models 20 22 127.3 ± 8.0 152.5 ± 29.6 0.001* Zhang et al [34] 3D virtual visualization 14 18 80.3 ± 4.8 90.7 ± 3 < 0.001*…”

Section: Discussionmentioning

confidence: 99%

“…Eventually, 22 articles were included for full-text screening of which two articles were excluded [14,15]. Twenty studies met the inclusion criteria of this systematic review [8,[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34]. The review process is summarized in Fig.…”

Section: Searchmentioning

confidence: 99%

“…Six studies reported on operation time [20,21,24,27,29,34], including one excellent quality, one good quality and 5 to −14.5) (Fig. 4).…”

Section: Operation Timementioning

confidence: 99%

“…Guo et al [21] 3D printed fracture models 14 14 314.3 ± 37.0 447.9 ± 31.1 < 0.05* Mean ± SD Lou et al [24] 3D printed fracture models 34 38 186.3 ± 5.5 216.2 ± 6.9 0.013* Ozturk et al [27] 3D printed fracture models 10 10 160.5 ± 15 276 ± 44 < 0.05* Shen et al [29] 3D printed fracture models 20 22 202.5 ± 36.3 266.4 ± 49.0 0.001* Zhang et al [34] 3D virtual visualization 14 18 95.7 ± 14.0 131.7 ± 16.2 < 0.001*…”

Section: Blood Loss (Ml)mentioning

confidence: 99%

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Does 3D-assisted surgery of tibial plateau fractures improve surgical and patient outcome? A systematic review of 1074 patients

Assink

Reininga

Duis

et al. 2021

Eur J Trauma Emerg Surg

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Purpose The aim of this systematic review was to provide an overview of current applications of 3D technologies in surgical management of tibial plateau fractures and to assess whether 3D-assisted surgery results in improved clinical outcome as compared to surgery based on conventional imaging modalities. Methods A literature search was performed in Pubmed and Embase for articles reporting on the use of 3D techniques in operative management of tibial plateau fractures. This systematic review was performed in concordance with the PRISMA-guidelines. Methodological quality and risk of bias was assessed according to the guidelines of the McMaster Critical Appraisal. Differences in terms of operation time, blood loss, fluoroscopy frequency, intra-operative revision rates and patient-reported outcomes between 3D-assisted and conventional surgery were assessed. Data were pooled using the inverse variance weighting method in RevMan. Results Twenty articles evaluating 948 patients treated with 3D-assisted surgery and 126 patients with conventional surgery were included. Five different concepts of 3D-assisted surgery were identified: ‘3D virtual visualization’, ‘3D printed hand-held fracture models’, ‘Pre-contouring of osteosynthesis plates’, ‘3D printed surgical guides’, and ‘Intra-operative 3D imaging’. 3D-assisted surgery resulted in reduced operation time (104.7 vs. 126.4 min; P < 0.01), less blood loss (241 ml vs. 306 ml; P < 0.01), decreased frequency of fluoroscopy (5.8 vs. 9.1 times; P < 0.01). No differences in functional outcome was found (Hospital for Special Surgery Knee-Rating Scale: 88.6 vs. 82.8; P = 0.23). Conclusions Five concepts of 3D-assisted surgical management of tibial plateau fractures emerged over the last decade. These include 3D virtual fracture visualization, 3D-printed hand-held fracture models for surgical planning, 3D-printed models for pre-contouring of osteosynthesis plates, 3D-printed surgical guides, and intra-operative 3D imaging. 3D-assisted surgery may have a positive effect on operation time, blood loss, and fluoroscopy frequency.

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Section: Discussionmentioning

confidence: 99%

Section: Searchmentioning

confidence: 99%

“…Six studies reported on operation time [20,21,24,27,29,34], including one excellent quality, one good quality and 5 to −14.5) (Fig. 4).…”

Section: Operation Timementioning

confidence: 99%

Section: Blood Loss (Ml)mentioning

confidence: 99%

See 2 more Smart Citations

Does 3D-assisted surgery of tibial plateau fractures improve surgical and patient outcome? A systematic review of 1074 patients

Assink

Reininga

Duis

et al. 2021

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

show abstract

“…However, because the fracture site is at the joint, accurate imaging diagnosis in clinical diagnosis and treatment can yield information on the patient’s fracture type and whether it will be associated with injuries in the follow-up treatment plan. Has an essential guiding role in the formulation[ 4 - 7 ]. X-ray examinations that have been commonly used in fracture diagnosis because of their weak fracture display ability can provide less diagnostic evidence and have gradually failed to meet the clinical needs of patients in practice.…”

Section: Introductionmentioning

confidence: 99%

Comparison between computed tomography and magnetic resonance imaging in clinical diagnosis and treatment of tibial platform fractures

Liu

Wang

Zhang

et al. 2020

WJCC

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BACKGROUND Tibial plateau fracture is one of the common fracture types. It occurs mainly in teenagers and is usually caused by a fall. After the occurrence of fracture, knee swelling, pain, limited activity, etc . greatly affect the patient’s exercise habits and lifestyle. X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) were used in this examination. X-rays are relatively new and easy to operate. However, there are some errors in the observation of fracture collapse and fracture displacement. In recent years, CT and MRI have been actively used to diagnose various types of clinical fractures. They have more diagnostic power than X-ray film. However, some scholars believe that CT is also prone to errors in clinical application. The volume effect leads to missed diagnosis and misdiagnosis in some cases, while the multidirection scanning of MRI technology can effectively overcome the shortcomings of CT. To facilitate the selection of clinical examination regimens, this study further observed the diagnostic ability of these two regimens in the diagnosis of tibial plateau fractures. AIM To explore the value of nuclear MRI and CT in the clinical diagnosis of tibial plateau fractures. METHODS A total of 120 patients with tibial plateau fractures admitted from September 2017 to August 2019 were included. All patients were examined by nuclear MRI and CT scanning. The results were sent to senior physicians in our hospital to complete the diagnosis. RESULTS Nuclear magnetic resonance showed the same effects as CT in four aspects: fracture displacement, bone defect, fracture site and fracture comminution. There was no significant difference in the score data ( P > 0.05). Nuclear magnetic resonance and CT tended to be consistent in the B3, C2 and C3 fracture diagnosis coincidence rate, combined injury detection rate and fracture detection rate. The diagnostic coincidence rate of type B1, B2 and C1 fractures and the accuracy rate of overall fracture classification indicated that the MRI technique was significantly better than that of CT ( P > 0.05). CONCLUSION MRI and CT have good diagnostic typing in the diagnosis of tibial plateau fractures, but MRI is more accurate and may be preferred.

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Clinical Comparison of the “Windowing” Technique and the “Open Book” Technique in Schatzker Type II Tibial Plateau Fracture

Ying

Liu

et al. 2022

Orthopaedic Surgery

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Objective: Surgical treatment for Schatzker type II tibial plateau fractures remains challenging and requires high-quality research. The aim of the study is to compare the "windowing" and "open book" techniques for the treatment of Schatzker type II tibial plateau fractures. Methods:In this prospective study, all patients with Schatzker type II tibial plateau fractures between January 2014 and December 2017 were managed by open reduction and internal fixation using an anterolateral incision approach. "Windowing" group included 78 patients (53 men and 25 women), with an average age of 57.7 AE 13.5 years, who underwent the "windowing" technique, in which the procedure was performed through a small cortical window against the depressed zone of the lateral plateau. The "open book" group included 80 patients (56 men and 24 women), with an average age of 54.8 AE 12.4 years, who underwent the technique. The clinical outcomes included the Rasmussen classification of knee function and grading of post-traumatic arthritis. The radiographic outcome (x-ray and computed tomography [CT]) was the reduction quality of the lateral plateau based on the modified Rasmussen radiological assessment. The patient-reported outcome was visual analogue scale (VAS) scores. Results:The mean follow-up time for the158 patients was 32 months (range, 24-42 months). The time elapsed from injury to surgery in "windowing" group and "open book" group were 3.7 AE 1.2 (range, 1-10 days) and 3.5 AE 1.4 days (range, 1-11 days), respectively, with no significant difference between the groups (P > 0.05). The operation times did not differ significantly between the "windowing" group (61.0 AE 8.3 min, range, 45-120 min) and the "open book" group (61.2 AE 10.4 min, range, 40-123 min) (P > 0.05). After surgery, CT revealed five (6.4%) and 15 (18.8%) cases of articular depression in the "windowing" and "open book" groups, respectively. Significant differences were observed in the articular depression of tibial plateau fractures between the groups (P < 0.05). However, condylar widening or valgus/varus did not differ significantly between the groups. Furthermore, no significant differences in knee function were observed during follow-up (P > 0.05). VAS scores were similar between the groups at 24 months after surgery (P > 0.05). There were significant differences in the number of severe post-traumatic arthritis (grades 2 and 3) cases between the groups (P < 0.05). Conclusions:The "windowing" and "open book" techniques are both effective for the treatment of Schatzker type II tibial plateau fractures. However, the "windowing" technique provides better reduction quality, leading to a satisfactory prognosis.

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Analysis for Clinical Effect of Virtual Windowing and Poking Reduction Treatment for Schatzker III Tibial Plateau Fracture Based on 3D CT Data

Cited by 7 publications

References 16 publications

Does 3D-assisted surgery of tibial plateau fractures improve surgical and patient outcome? A systematic review of 1074 patients

Does 3D-assisted surgery of tibial plateau fractures improve surgical and patient outcome? A systematic review of 1074 patients

Comparison between computed tomography and magnetic resonance imaging in clinical diagnosis and treatment of tibial platform fractures

Clinical Comparison of the “Windowing” Technique and the “Open Book” Technique in Schatzker Type II Tibial Plateau Fracture

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