摘要
目的探讨3D打印模板技术在桡骨远端C型骨折手术设计中的应用效果。方法回顾性分析2015年6月至2018年5月在广州医科大学附属深圳沙井医院手外科行手术治疗的30例桡骨远端C型骨折患者的临床资料,其中,以术前在电脑中利用Mimics 20.0软件先建立骨折3D数字模型,在电脑中通过3D数字模型了解骨折形态并模拟骨折复位,利用3D打印机打印出1∶1的骨折实体模板,在实体模板上模拟手术过程并选择合适的钢板及螺钉固定孔位的15例患者纳入实验组;15例通过传统影像学资料了解骨折形态及进行术前设计者纳入对照组。比较两组患者的手术时间、术中出血量和术后腕关节Gartland-Werley评分。结果30例患者均顺利完成手术,术后伤口Ⅰ期愈合,所有患者均获得随访,时间为10~18个月,平均约12个月,两组患者均达到骨性愈合;实验组患者的手术时间为(69.00±6.34)min,明显短于对照组的(73.93±6.34)min,术中出血量为(29.67±6.40)m L,明显少于对照组的(35.00±6.27)mL,差异均有统计学意义(P<0.05);末次随访腕关节功能根据Gartland-Werley评分,实验组优良率为86.67%,略高于对照组的73.33%,但差异无统计学意义(P>0.05)。结论应用3D打印模板技术辅助进行桡骨远端C型骨折的手术设计比传统的利用影像学资料进行术前设计更加直观、真实,缩短手术时间,减少术中对周围组织不必要的损伤,达到对患者个体化、精确化的治疗。
Objective To investigate the effects of the application of 3D printing technique in the surgical planning of type-C distal radius fractures.Methods A retrospective analysis was performed on 30 cases of type-C distal radius fractures undergoing surgical treatment in the Department of Hand Surgery,Shenzhen Shajing People’s Hospital,Guangzhou Medical University,from June 2015 to May 2018.Among the 30 cases,15 were divided into experimental group,which applied Mimics 20.0 software to reconstruct 3 D digital model of the fracture in computer.The 3 D digital model,more information about fracture was obtained and virtual fracture reduction was performed.Then a fracture reduction was simulated on a real-size 3 D printing solid model,and the appropriate plate and screw fixing holes was preselected.The rest 15 cases were divided into control group,which applied conventional surgical planning by X-ray and CT imaging data.The operation time,intraoperative blood loss,and Gartland-Werley scores were compared between two groups.Results Thirty patients were successfully operated with primary wound healing.All cases were followed up from 10 to 18 months postoperatively,with an average of 12 months.The fractures achieved bony union in all groups.The operation time of the experimental group was(69.00±6.34)min,significantly shorter than(73.93±6.34)min of the control group;the intraoperative blood loss of the experimental group was(29.67±6.40)mL,significantly less than(35.00±6.27)mL in the control group;the differences were all statistically significant(P<0.05).As of the last follow-up,the excellent and good rate of wrist functional of experimental group was 86.67%,slightly higher than 73.33%in the control group(P>0.05).Conclusion The application of 3 D printing technique in the surgical planning of type-C distal radius fractures is more intuitive than the conventional way,which can lead to shorter operation time,less trauma and achieve personalized and precise treatment.
作者
林慧鑫
李征
余少校
柯于海
曾锦浩
李东扬
张振伟
LIN Hui-xin;LI Zheng;YU Shao-xiao;KE Yu-hai;ZENG Jin-hao;LI Dong-yang;ZHANG Zhen-wei(Department of Hand Surgery,Shenzhen Shajing People's Hospital,Guangzhou Medical University,Shenzhen 518104,Guangdong,CHINA)
出处
《海南医学》
CAS
2020年第14期1807-1810,共4页
Hainan Medical Journal
基金
广东省深圳市宝安区科技计划项目(编号:20170620114855284)。
