摘要
目的观察应用3D打印技术个体化定制支具非手术治疗腱性锤状指疗效。方法 2015年6月—2016年12月哈尔滨市第五医院收治44例闭合腱性锤状指患者。根据治疗方法将患者分为3D组和普通支具组,各22例22指。3D组应用自行研制锤状指复位体位支具,3D扫描后打印。普通支具组应用传统支具非手术治疗腱性锤状指患者。并依据手功能Patel评定法对患指功能进行评价。结果所有患者均8周拆除外固定,经功能练习,远指间关节(distal interphjalangeal joint,DIP)背伸功能均恢复良好,近指间关节(proximal interphjalangeal joint,PIP)无挛缩屈伸活动度良好。随访3～12个月,平均6.6个月,无失访,依据手功能Patel评定法,3D组优15例,良7例;普通支具组优6例,良16例。3D组支具所有患者未发生支具折断、碎裂、损坏情况,无固定失效情况发生,无一例产生压疮,2例患者因肿胀消褪二次更换支具。而普通支具组2例患者产生压疮,5例患者因支具固定失效二次更换支具。结论 3D支具固定可靠,不易形成压疮,便于观察甲板血运,指体肿胀消褪后可再次依据伤指外形快速打印更换支具,并且费用低廉,是一种治疗腱性锤状指理想有效的治疗方式。
Objective To observe the effect of 3D printing technique in treating tendinous mallet finger. MethodsFrom Jun. 2015 to Dec. 2016, 44 closed tendionous mallet finger patients were admitted to the Fifth Hospital of Harbin. Patients were randomly divided into 3D printing brace group and traditional brace group according to different treating methods, with 22 patients in each group. Patients were evaluated according to the hand function Patel scoring standard. ResultsAll patients were removed brace after 8 weeks. After function rehabilitation, distal interphjalangeal joint obtained good extension function, and proximal interphalangeal joint had no contracture and had good mobility. All patients were followed up for 3 to 12 months with an average of 6.6 months. According to the Patel scoring standard, the 3D printing brace group showed excellent in 15 cases, good in 7 cases, while the traditional brace group showed excellent in 6 cases, and good in 16 cases. No patient in the 3D printing brace group had brace breakage, fragmentation, damage, or fixation failure, and 2 patients had replaced brace due to swelling subsides. In the traditional brace group, 2 patients developed pressure sores, and 5 patients had the brace changed due to fixation failure. Conclusion The 3D printing brace has advantages of firm fixation, less pressure sores, easy to observe the blood supply of the nail bed, and low cost. Hence, it is an ideal and effective treatment way for tendinous mallet finger.
作者
聂广辰
石健
刘勇
房玉利
陈一凡
薛岩
刘丽
丛晓丹
郝旭光
李佳铭
李鹏伟
NIE Guang-chen;SHI Jian;LIU Yong;FANG Yu-li;CHEN Yi-fan;XUE Yan;LIU Li;CONG Xiao-dan;HAO Xu-guang;LI Jia-ming;LI Peng-wei(Department of Orthopedics, the Fifth Hospital of Harbin,Harbin150000,China;The Instiute of Automation of Heilongjiang Academy of Sciences, Harbin150090, China)
出处
《创伤外科杂志》
2019年第4期262-266,共5页
Journal of Traumatic Surgery
关键词
锤状指
闭合损伤
非手术治疗
3D打印
个体化
mallet fingers
closed injury
non-surgical treatment
3D printing
individualized
