3D打印技术在骨盆骨折前路微创手术中的应用  

Application of 3D printing technology in minimally invasive surgery of pelvic fractures

作　　者：袁志根[1] 付三清[1] 蒋国安[1] 米雷[1] 

机构地区：[1]湖南省第二人民医院创伤骨科,湖南长沙410007

出　　处：《中国骨与关节损伤杂志》2018年第2期117-119,共3页Chinese Journal of Bone and Joint Injury

基　　金：湖南省卫生计生委科研计划课题(C2017048)

摘　　要：目的探讨3D打印技术在骨盆骨折前路微创手术术前规划及术中指导的应用价值。方法回顾性分析自2015-07—2016-07采用3D打印技术辅助前路微创手术治疗的13例骨盆前环骨折。术前行三维CT扫描,按照1∶1比例3D打印骨盆骨折模型,在模型上设计切口,模拟骨折复位,对钢板进行塑形。术中根据术前预手术行骨折复位,再将已经塑形的重建钢板置于目标位置,最后置入合适长度螺钉。结果本组手术时间60~89 min,平均73 min;出血量80~270 ml,平均158 ml。采用Matta标准评定骨折复位质量:优10例,良1例,可2例。13例均获得随访,随访时间平均8.2(6~12)个月。骨折均临床愈合,愈合时间平均19(11~35)周。末次随访时Majeed评分:优11例,良1例,可1例。无感染、股神经或股血管损伤、股骨头缺血性坏死、钢板松动脱出等并发症发生。结论 3D打印技术辅助前路小切口微创手术治疗骨盆骨折可以减少手术创伤、缩短手术时间、提高骨折复位质量及固定效果,手术安全性高。Objective To explore the value of 3D printing technology application in preoperative planning and conducting during the minimally invasive surgery of pelvic fractures. Methods From July 2015 to July 2016, 13 patients with pelvic fractures were fixed through minimally invasive incision approach. All patients underwent preoperative CT scan. Then pelvic models were printed suing 3D printing technology at 1：1 proportion. Operative process was conducted on the model, including the design of the incision, design of fracture reduction, moulding of the plate. Pre-bent reconstruction plate was placed on the bone surface from internal or external incision. Results The operation time was 60-89 min, average 73 min. Intraoperative blood loss was 80-270 ml, average 158 ml. All the patients were followed up for 6 to 12 months with an average of 8.2 months. All fractures healed. According to Matta reset standards, the reduction of the pelvic fractures was excellent in 10 cases, good in 1 case, fair in 2 cases. According to Majeed score, excellent results were in 11 cases, good in 1 case, fair in 1 case. No infection, injury of the femoral nerve, avascular necrosis, loosening of plates and screws were found. Conclusion Application of 3D printing technology in the minimally invasive surgery of pelvic fractures can minimize the incision, reduce surgery time, conduct accurate reduction and make procedure more secure.

关 键 词：骨盆骨折 3D打印技术 微创 内固定 

分 类 号：R687.3[医药卫生—骨科学]