摘要
背景:复杂髋臼骨折的治疗目前仍然是骨科医生面临的最具挑战性的任务之一,骨折的准确评估和术前计划对于良好的复位至关重要。采用计算机辅助虚拟手术程序以及患者个体化的3D打印模型预成型钢板为复杂髋臼骨折提供了准确、合理的手术方案。目的:评估基于3D打印技术的术前虚拟仿真计划在复杂髋臼骨折手术治疗中的可行性、准确性和有效性。方法:选择2018年3月至2020年8月滕州市中心人民医院创伤骨科收治的28例复杂髋臼骨折患者,随机分为2组。试验组13例采用基于3D打印技术的术前虚拟仿真计划,钢板预成型进行切开复位钢板内固定;对照组15例采用传统方法进行切开复位钢板内固定。比较两组患者术中情况和术后疗效。结果与结论:(1)试验组的手术时间、术中出血量、术中输血量、术中透视次数、术中器械时间均少于对照组,差异有显著性意义(P<0.05);两组患者的住院时间比较,差异无显著性差异(P>0.05);(2)两组患者术后随访6-18个月,试验组患者的并发症发生率、骨折愈合时间均优于对照组,差异有显著性意义(P<0.05);(3)试验组患者的术后即刻骨折复位质量Matta影像学评分、末次随访时髋关节功能Merle d’Aubigne&Postel评分高于对照组,差异有显著性意义(P<0.05);(4)提示基于3D打印技术的术前虚拟仿真计划是可行的、准确的,可为复杂髋臼骨折的术前计划和精确固定提供有效手段,从而改善修复效果。
BACKGROUND:The treatment of complex acetabular fractures is still one of the most challenging tasks for orthopedic surgeons.Accurate fracture assessment and preoperative planning are very important for good reduction.Computer-aided virtual surgery program and three-dimensional(3 D)printing of patientspecific pre-contoured plates provide an accurate and reasonable surgical plan for complex acetabular fractures.OBJECTIVE:To evaluate the feasibility,accuracy and effectiveness of preoperative virtual simulation plan based on 3 D printing technology in the surgical treatment of complex acetabular fractures.METHODS:From March 2018 to August 2020,28 patients with complicated acetabular fractures were selected from Department of Orthopedic Trauma,Tengzhou Central People’s Hospital and randomly divided into two groups.The 13 cases in the experimental group were treated with preoperative virtual simulation plan based on 3 D printing technology;pre-contoured plates for open reduction and internal fixation of steel plate.The 15 cases in the control group were treated with traditional treatment plan:open reduction and internal fixation of steel plate.Intraoperative condition and postoperative curative effect were compared between the two groups.RESULTS AND CONCLUSION:(1)The operation time,intraoperative blood loss,intraoperative blood transfusion,intraoperative fluoroscopy times and intraoperative instrument time of the experimental group were all less than those of the control group,with significant difference(P<0.05).There was no significant difference in hospitalization time between the two groups(P>0.05).(2)Patients in both groups were followed up for 6-18 months.The incidence of complications and fracture healing time in the experimental group were better than those in the control group,and the difference was statistically significant(P<0.05).(3)Matta imaging score of fracture reduction quality immediately after operation and Merle d’Aubigne&Postel score of hip joint function at the last follow-up in the experimental group were higher than those in the control group,with significant difference(P<0.05).(4)It is suggested that the preoperative virtual simulation plan based on 3 D printing technology is feasible and accurate,which provides an effective means for preoperative planning and precise fixation of complex acetabular fractures,thus improving the postoperative effect.
作者
宋远征
马红丽
李玮
满佳
林峰
张玉东
Song Yuanzheng;Ma Hongli;Li Wei;Man Jia;Lin Feng;Zhang Yudong(Tengzhou Central People’s Hospital Affiliated to Jining Medical University,Tengzhou 277599,Shandong Province,China;Key Laboratory of High Efficiency and Clean Mechanical Manufacture(Ministry of Education),School of Mechanical Engineering,Shandong University,Jinan 250061,Shandong Province,China;Basic Surgery Teaching Experimental Center,Clinical Medical School,Xuzhou Medical University,Xuzhou 221004,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第36期5747-5752,共6页
Chinese Journal of Tissue Engineering Research
基金
徐州医科大学校级科研课题资助项目(2017KJ07),项目负责人:张玉东。
关键词
3D打印
髋臼骨折
计算机辅助
虚拟仿真
术前规划
预成型钢板
骨折复位
髋关节功能
three-dimensional printing
acetabular fracture
computer-aided
virtual simulation
preoperative planning
pre-contoured plates
reduction of fracture
hip joint function
