3D打印技术辅助复杂髋臼骨折治疗的临床研究  

The comparative research on the surgical treatment result of complex acetabula fracture assisted by 3D printing technology

作　　者：漆启华[1] 鲍坤旺[1] 肖强[1] 邓亮[1] 李晨[1] 曾纪焕[1] 袁中平[1] 董谢平[1] QI Qihua, BAO Kunwang, XIAO Qiang, DENG Liang, LI Cheng, ZENG Jihuan, YUAN Zhongping, DONG Xieping.(The 2al Deptment of Orthopaedics, Jiangxi People＇s Hospital, Nanchang 330006, Chin)

机构地区：[1]江西省人民医院骨二科,南昌330006

出　　处：《实用医学杂志》2018年第5期750-754,共5页The Journal of Practical Medicine

基　　金：江西省科技支撑计划资助项目(编号:20151B BG70119)

摘　　要：目的比较传统手术(A组)与3D打印辅助手术(B组)治疗复杂髋臼骨折的近期临床效果。方法分析我院行手术治疗的35例复杂髋臼骨折患者资料,其中13例患者行3D打印辅助设计手术,依此对髋臼骨折做出明确的诊断、分型,术前模拟复位固定手术。余22例患者行常规手术,比较两组手术创伤程度及全身炎性反应,Matta影像学评定术后骨折块即刻复位效果,Merled′Aubigne和Postel评分,髋关节活动功能评分评价术后康复功能状态。结果两组手术时间、术中出血量、术后引流量比较有统计学意义(P<0.05),B组优于A组。A组术后24 h外周血C反应蛋白、白细胞计数以及肌酸激酶较术前明显升高,两组间比较差异显著(P<0.01),术后即刻复位效果B组优于A组,优良复位率达84.6%,两组比较差异有统计学意义(P=0.034),末次随访改良的Merled′Aubigne和Postel评分A组优良率为50%,B组为92.3%,两组比较有统计学意义(P=0.013)。B组髋关节Harris功能评分优良率明显高于A组(P=0.027)。结论 3D打印技术辅助复杂髋臼骨折手术治疗创伤小,术后复位效果好,近期疗效满意,长期效果有待于进一步随访结果。Objective To evaluate the advantage of 3D printing technique in treatment of complicated acetabula fracture, we compared the early clinical outcomes of surgical treatment for complex aeetabula fracture with traditional surgery （group A） and that assisted by 3D printing technique （group B）. Methods A prospective anal- ysis of 35 complicated acetabula fractures was performed at our department, 13 patients cured assisted with 3D printing technique. The other 22 patients performed traditional surgery. Surgical trauma, systematic inflammation, immediate reduction effect were evaluated by Matta image assessment standard, and rehabilitation functional status evaluated by Harris score system and Merled＇ Aubigne and Postel Grading standard. Results There were signifi- cant differences between the two groups regarding intraoperative blood loss, postoperative drainage, operation time （P 〈 0.05 ）, and group B was superior to group A. C reactive protein, leucocyte and creatine kinase MM in periph- eral blood in group A were much higher than those in group B at 24 hours postoperatively （P 〈 0.01 ）. The result of reduction of fracture is poor in group A, but excellent rate of reduction is about 84% in group B. The result of Merled＇ Aubigne and Postel scores grading was superior in group B （P = 0.013）. The excellent and good rate of Harris function score in B group was significantly higher than that in group A （P = 0.027 ）. Conclusion The treat- ment of complicated acetabula fracture assisted by 3D printing is excellent in short-term follow up, achieving good reduction with limited trauma, long-term prognosis needs to be further followed up.

关 键 词：髋臼骨折 3D打印技术 解剖复位 

分 类 号：R687.3[医药卫生—骨科学]