3D打印技术在陈旧性骨盆髋臼骨折治疗中的应用  

Application of 3D printing technique in treatment of obsolete pelvic and acetabular fractures

作　　者：仇道迪 周东生[1] 许维澄[1] 张国明[1] 冯立[1] 陈龙[1] 孙金磊[1] 

机构地区：[1]山东大学附属省立医院创伤骨科,济南250021

出　　处：《中华创伤骨科杂志》2017年第7期624-629,共6页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨3D打印技术在陈旧性骨盆髋臼骨折治疗中的应用价值。方法回顾性分析2006年1月至2016年1月收治的23例陈旧性骨盆髋臼骨折患者资料。根据是否使用3D打印技术将患者分为2组：应用3D打印技术进行术前计划（3D组）11例，男8例，女3例，平均年龄（33．8±4．9）岁；未应用3D打印技术（常规组）12例，男9例，女3例，平均年龄（34．8±8．3）岁。初次骨盆骨折按Tile分型均为C型。3D组和常规组患者合并髋臼骨折分别有10、11例。观察并比较两组患者手术时间、术中出血量、围手术期输血量、术中透视次数、术后疼痛视觉模拟评分（VAS）、骨盆骨折Majeed评分等指标。结果两组患者术前一般资料比较差异均无统计学意义（P〉0．05），具有可比性。3D组和常规组患者手术时间平均分别为（166．4±24．2）、（222．5±49．0）min，术中出血量平均分别为（2063．6±484．3）、（2700．0±597．0）mL，围手术期输血量平均分别为（13．2±3．2）、（17．6±4．5）U，术中透视次数平均分别为（7．4±1．3）、（11．7±3．6）次；以上项目两组间比较差异均有统计学意义（P〈0．05）。3D组和常规组患者术后分别获平均18．4、21，7个月随访。3D组和常规组患者术后VAS评分平均分别为（1．8±0．9）、（3．4±1．0）分，差异有统计学意义（P〈0．05）。末次随访时3D组和常规组Majeed评分平均分别为（85．7±4．2）、（84．9±3．1）分，差异无统计学意义（P〉0．05）。3D组患者术后无一例患者发生医源性神经、血管损伤、骨不愈合、内固定失败等并发症。常规组术后1例患者发生一过眭医源性坐骨神经损伤。结论3D打印技术可用于陈旧性骨盆髋臼骨折的术前诊断分型，充分指导手术计划，有助于术中精确复位、缩短手术时间、减少术中出血量和术中透视次数，提高陈旧性骨盆髋�Objective To investigate the application-of 3D printing technique in the treatment of ob- solete pelvic and acetabular fractures. Methods The clinical data of 23 patients with obsolete pelvic and acetabular fractures were retrospectively analyzed who had been surgically treated in our hospital from January 2006 through January 2016. 3D printing technique was used in surgical planning in 11 of them, including 8 males and 3 females, with an average age of 33.8 ±4.9 years （3D group） . The other 12 patients received conventional surgery without using 3D printing technique. They were 9 males and 3 females, with an average age of 34. 8 ± 8.3 years （conventional group）. The primary pelvic fractures in both groups were all type C according to the Tile classification system. The patients complicated with acetabular fracture in the 3D group and the conventional group were 10 and 11 cases respectively. The operative time, blood loss, blood transfusion, intraoperative fluoroscopy, visual analogue score （VAS） and Majeed score were compared between the 2 groups. Results The 2 groups were compatible in terms of preoperative general data （ P 〉 0.05）. For the 3D group and the conventional group, operative time was 166.4± 24.2 rain versus 222.5 ±49.0 min, blood loss 2,065.6 ±484.3 mL versus 2, 700.0 ±597.0 mL, blood transfusion 13.2 ±3.2 U versus 17.6 ±4.5 U, and intraoperative fluoroscopy 7.4 ± 1.3 times versus 11.7 ± 3. 6 times. There were significant differences be- tween the 2 groups in the above indexes （ P 〈 0.05） . The 3D group and the conventional group obtained an average follow-up of 18.4 months and 21.7 months, respectively. The postoperative VAS scores were respectively 1.8 ± 0. 9 points and 3.4 - 1.0 points for the 2 groups, showing a significant between-group difference （ P 〈 0. 05）. The Majeed scores at the last follow-ups were respectively 85.7 ± 4. 2 points and 84. 9 ± 3. 1 points for the 2 groups, showing no significant between-group difference （ P 〉 0.05 ）. There

关 键 词：骨盆 髋臼 骨折 3D打印 

分 类 号：R687.3[医药卫生—骨科学] TP391.73[医药卫生—外科学]