摘要
[目的]介绍3D打印导板辅助转子间外翻截骨治疗青壮年股骨颈骨不连的手术技术与初步疗效。[方法] 2012年9月~2019年12月,8例股骨颈骨不连患者接受此技术外翻截骨治疗。术前对双髋行CT容积扫描,数据经Mimics软件处理建立3D股骨近段模型,模拟转子间截骨和DHS固定,并设计制作实际导板。实际手术中利用导板辅助,对转子间进行外翻截骨并利用DHS进行内固定。[结果]所有患者均顺利手术,无严重并发症。末次随访时8例患者Harris评分和患肢长度均较术前显著增加(P<0.05)。影像方面,术后颈干角较术前显著增加(P<0.05),且显著大于健侧(P<0.05);术后Pauwels角较术前显著减小(P<0.05),且与术前设计预期Pauwels角的差异无统计学意义(P>0.05)。[结论] 3D导板辅助下转子间外翻截骨治疗股骨颈骨不连手术过程更准确、操作简便。
[Objective] To introduce the surgical technique and primary clinical outcomes of 3D-printed guider assisted intertrochanteric valgus osteotomy for treatment of femoral neck nonunion in young adults. [Methods] From September 2012 to December 2019, a total of 8 young patients underwent this surgical intervention for nonunion of femoral neck fractures secondary to the primary surgeries. Before the operation, CT volume scanning was conducted on both hips, and then the CT data were processed by using Mimics software to create 3D digital models of the femurs. As osteotomy mimicked on the models, a guider was designed, followed by the real guider made with 3D printer. During the clinical operation, the real guider was used for intertrochanteric valgus osteotomy and internal fixation with dynamic hip screw. [Results] All the 8 patients had operation performed successfully without serious complication. The Harris score and length of the effected low extremity significantly improved at the latest follow-up compared with those before operation(P<0.05). In term of radiographic evaluation, the femoral neck-shaft angle significantly increased at the latest follow-up in the affected side compared with that before operation(P<0.05), which was also significantly greater than that on the uninvolved side(P<0.05). However, the Pauwels angle significantly decreased at the finial interview in contrast with that preoperatively(P<0.05), which proved not statistically different to that designed preoperatively(P>0.05). [Conclusion] This 3D-printed guider does facilitate to surgical procedure with improving accuracy of intertrochanteric valgus osteotomy for treatment of femoral neck nonunion in young adults.
作者
许春涛
王平山
曹学成
张贵春
张强
刘亚
XU Chun-tao;WANG Ping-shan;CAO Xue-cheng;ZHANG Gui-chun;ZHANG Qiang;LIU Ya(Department of Traumatic Orhopedics,The 960^(th)Hospial,Joint Logistic Support Force of PLA,Jinan 250031,China)
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2021年第2期166-169,共4页
Orthopedic Journal of China
关键词
股骨颈骨折
骨不连
导板
转子间外翻截骨
青壮年
femoral neck fracture
nonunion
guider
intertrochanteric valgus osteotomy
young adult
