3D打印与腹腔镜辅助的髋臼骨折手术策略  

Operative strategy for acetabulum fracture with laparoscopic assistance and three-dimentional printing technique

作　　者：曾参军[1] 黄文华[2] 韩卫雨[1] 张国栋[2] 黄华军[2] 吴章林[2] 金大地[1] 

机构地区：[1]南方医科大学第三附属医院创伤骨科(广东省骨科研究院),广州510630 [2]南方医科大学基础医学院,广州510515

出　　处：《中华关节外科杂志（电子版）》2015年第1期18-20,共3页Chinese Journal of Joint Surgery(Electronic Edition)

基　　金：863计划(2012AA02A603)

摘　　要：目的探讨髋臼骨折患者采用3D打印仿真骨盆模型体外模拟手术后微创腹腔镜辅助下钢板内固定髋臼骨折手术方案。方法筛选1例髋臼骨折患者,先将患者骨盆CT薄层扫描数据用DICOM格式导入Mimics软件进行三维编辑、虚拟手术复位骨折,采用3D技术打印患者仿真骨盆模型,并进行钢板螺钉最佳位置设计、钢板预弯、螺钉长度测量、螺钉进入途径设计等一系列术前模拟手术,然后在腹腔镜辅助下腹膜外间隙复位骨折、钢板内固定术。结果采用3D打印腹腔镜辅助下髋臼骨折手术成功完成,相对传统手术,该手术方式创伤小、切口小、出血少、术后疼痛轻,术后更早进行功能锻炼。结论 3D打印技术体外模拟手术可使手术更加精准、安全、完美。腹腔镜辅助下微创治疗减少了患者痛苦,缩短患者康复周期,使患者早日重返工作岗位,从而减少住院日,降低医疗成本,同时大大减少了出血量,为社会节约了血源。Objective To explore the effectiveness of internal fixation with reconstruction for the acetabulum fracture with the assistance of laparoscopy and virtual surgery simulation on three-dimensional（ 3D） printed model of the patient＇s pelvis. Methods One patient with acetabular fracture was selected for the surgery. The data of thin-slice CT scan of the patient ＇s pelvis were imported into Mimics（ a professional software） as DICOM format for 3D edit and the virtual fracture reduction. A model of the patient＇s pelvis was developed by 3D printing technique for a series of preoperative simulations,such as designing the optimal position of plate and screws,prebending the plate,measuring the length of screws,and designing the approach for screws insertion. The reduction and internal fixation was performed by the extraperitoneal approach with the assistance of laparoscopy. Results The first acetabular fracture surgery assisted by 3D printing technique and laparoscopy of the world was performed successfully. Compared with the traditional surgery,this new method had the advantages of smaller incision,minimal invasion,less bleeding,mild postoperative pain,and much earlier functional exercise. Conclusion The surgery can be performed more accurately,safely and perfectly after the preoperative simulation with the 3D printed model. With the assistance of laparoscopy,the surgery may benefit the patient with less pain,earlier recovery,shorter duration of hospital stay,less cost,and less blood loss so that blood resources will be economized.

关 键 词：打印 三维 腹腔镜 髋臼 骨折 内固定器 

分 类 号：R687.3[医药卫生—骨科学]