3D打印技术用于复杂髋臼骨折围手术期的效果-现代医学

3D打印技术用于复杂髋臼骨折围手术期的效果

单位：十堰市太和医院/湖北医药学院附属太和医院创伤骨科, 湖北十堰 442000

分类号：R683.42

出版年·卷·期（页码）：2019·47·第八期（892-895）

摘要：

目的：分析3D打印技术进行虚拟术前规划与手术模拟，并应用于髋臼骨折治疗中的效果。方法：回顾性分析61例复杂髋臼骨折患者的病例资料与随访结果，将患者依据手术方式分为3D打印技术组（22例）与经验性手术组（49例）。比较两组患者的手术时间、术中失血量、输血总量、术中透视次数、复位情况等。结果：所有患者手术成功，3D打印技术组的术中失量、输血总量、术中平均透视次数少，手术时间显著比经验性手术组短（P<0.05）。Matta评分、末次随访时改良Merle d'Aubigne&Postel评分差异无统计学意义（P>0.05）。两组不良反应发生比例差异无统计学意义。结论：3D打印技术有利于直观规划复杂髋臼骨折手术，能有效提高手术效率。

Objective:To analyze the preoperative planning and surgical simulation of 3D printing technology in thetreatment of acetabular fractures.Methods:Clinical data and follow-up results of 61 patients with acetabular fractures were retrospectively analyzed. The patients were divided into 3D printing group (22 patients) and experiential operation group (49 people) according to the operation mode. SPSS software was used to analyze the operation time, intraoperative blood loss, total number of blood transfusion, intraoperative fluoroscopy times, reduction of the two groups of patients.Results:All patients were successfully operated. In 3D printing group, intraoperative blood loss, total blood transfusion, intraoperative fluoroscopy times were less than that in the experiential operation group, and the operation time was significantly shorter than that of the empirical operation group (P<0.05). Matta score and modified Merle d'Aubigné-Postel score had no significant difference(P>0.05). There was no significant difference in the incidence of adverse reactions between the two groups.Conclusion:3D printing technology is beneficial to the visual planning of acetabular fracture surgery, and can effectively improve the operation efficiency.

参考文献：

[1] MOED B R,KREGOR P J,REILLY M C,et al.Current management of posterior wall fractures of the acetabulum[J].Instr Course Lect,2015,64:139-159.
[2] ROMMENS P M,HESSMANN M H.Acetabulum fractures[J].Unfallchirurg,1999,102(8):591-610.
[3] 王钢.骨盆与髋臼骨折治疗值得注意的问题[J].中国骨科临床与基础研究杂志,2011,3(2):85-88.
[4] 刘莹松,杨述华.髋臼骨折外科治疗进展[J].国际骨科学杂志,2010,31(3):145-147.
[5] BAGARIA V,DESHPANDE S,RASALKAR D D,et al.Use of rapid prototyping and three-dimensional reconstruction modeling in the management of complex fractures[J].Eur J Radiol,2011,80(3):814-820.
[6] HERLIN C,KOPPE M,BEZIAT J L,et al.Rapid prototyping in craniofacial surgery:Using a positioning guide after zygomatic osteotomy-A case report[J].J Craniomaxillofac Surg,2011,39(5):376-379.
[7] 曾参军,谭新宇,黄华军,等.基于3D打印的腹直肌旁切口治疗骨盆骨折的临床疗效[J].南方医科大学学报,2016,36(2):220-225.
[8] 李宝丰,章莹,邰国良,等.3D数字骨科技术在髋臼骨折治疗中的应用[J].南方医科大学学报,2016,36(7):1014-1017.
[9] 聂喜增,刘金辉,李锋,等.3D打印技术在复杂骨盆及髋臼骨折手术中的应用[J].当代临床医刊,2016,29(3):2198-2199.
[10] LETOURNEL E.Acetabulum fractures:classification and management[J].Clin Orthop Relat Res,1980,151(151):81-106.
[11] KEEL M,ECKERT M,CULLMANN J L,et al.The pararectus approach for anterior intrapelvic management of acetabular fractures:an anatomical studyand clinical evaluation[J].J Bone Joint Surg Br,2012,94 (3):405-411.
[12] MATTA J M.Fractures of the acetabulum:accuracy of reduction and clinical results in patients managed operatively within three weeks after injury[J].J Bone Joint Surg,1996,78(11):1632-1645.
[13] JUDET R,JUDET J,LETOURNEL E.Fractures of the acetabulum:classification and surgical approaches for open reduction.Preliminary report[J].J Bone Joint Surg Am,1964,46(8):1615-1646.
[14] GANSSLEN A,FRINK M,HILDEBRAND F,et al.Both column fractures of the acetabulum:epidemiology,operative management and longterm-results[J].Acta Chir Orthop Traumatol Cech,2012,79(2):107-113.
[15] 唐天华,唐三元,杨辉.髋臼骨折手术人路与并发症关系的研究进展[J].中华创伤骨科杂志,2014,16(2):169-172.
[16] ATESOK K,SCHEMITSCH E H.Computer-assisted trauma surgery[J].J Am Acad Orthop Surg,2010,18(5):247-258.
[17] YANG L,SHANG X W,FAN J N,et al.Application of 3D printing in the surgical planning of trimalleolar fracture and Doctor-Patient communication[J].Biomed Res Int,2016(420):1-5.
[18] YU A W,DUNCAN J M,DAURKA J S,et al.A feasibility study into the use of three-dimensional printer modelling in acetabular fracture surgery[J].Adv Orthop,2015,2015:617046.
[19] SCIBERRAS N,FRAME M,BHARADWAJ R,et al.A novel technique for pre-operative planning of severe acetabular defects during revision hip arthroplasty[J].Bone Joint Surg,2013,95-B(Suppl 30):63.

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