3D打印钢板在儿童骨折内固定手术中的应用研究  

Application of 3D printing plate in internal fixation of children fracture

作　　者：李振威 蒋玮[1] 桂斌捷[1] 孙和炎[1] LI Zhen-wei;JIANG wei;GUI Bin-jie;SUN He-yan(Department of Osteoarthritis and Microsurgery,the First Affiliated Hospital of Anhui Medical University,Hefei 230022,A nhui,China)

机构地区：[1]安徽医科大学第一附属医院骨关节与显微修复外科,安徽合肥230022

出　　处：《生物医学工程与临床》2018年第5期546-550,共5页Biomedical Engineering and Clinical Medicine

摘　　要：目的探讨3D打印钢板在儿童股骨远端骨折中的应用价值。方法选择股骨远端骨折患儿46例,其中男性26例,女性20例,年龄4~14岁,平均年龄8.82岁。采用随机数字表法将全部患儿分为2组,即对照组和研究组。对照组23例,其中男性12例,女性11例;年龄4~13岁,平均年龄8.74岁。研究组23例,其中男性14例,女性9例;年龄4~14岁,平均年龄8.98岁。研究组给予切开复位3D打印钢板内固定治疗,利用计算机辅助设计模拟复位内固定,并设计内固定钢板,采用3D打印快速成型技术以钛合金为原材料打印钢板植入人体。对照组给予常规切开复位重建钢板塑形后内固定治疗。观察2组患儿手术时间、术中出血量、住院时间、骨折愈合时间、并发症发生率和手术效果。结果研究组手术时间[(71.24±18.27)min]、术中出血量[(81.05±27.32)mL]、住院时间[(15.17±3.26)d]、骨折愈合时间[(63.24±10.66)d]均显著低于对照组[(93.54±23.65)min、(114.62±38.65)mL、(18.24±5.38)d、(84.37±12.08)d],差异均有统计学意义(P<0.05)。研究组材料轴向压缩、扭转、轴向压缩破坏与对照组比较,差异无统计学意义(P>0.05)。研究组随访期间并发症发生率显著低于对照组,差异有统计学意义(4.35%vs 26.09%;χ~2=4.212,P<0.05)。研究组手术优良率显著高于对照组,差异有统计学意义(100.00%vs 78.26%;χ2=2.176,P<0.05)。结论 3D打印钢板在儿童股骨远端骨折的治疗中有着明显优势,有助于优化手术方案,缩短手术时间和骨折愈合时间,提高手术成功率,降低手术并发症,在儿童骨折切开复位内固定手术中具有广阔的应用前景。Objective To investigate the application value of three-dimensional（3 D） printing plate in distal femoral fracture in children. Methods A total of 46 children with distal femur fractures were enrolled, which included 26 males and 20 females,aged 4-14 years old with mean age of 8.82 years old. According to random number table, patients were divided into control group（n = 23, included 12 males and 11 females; aged 4-13 years old with mean age of 8.74 years old） and study group（n =23, which included 14 males and 9 females; aged 4-14 years old with mean age of 8.98 years old）. The study group was treated with open reduction 3 D printing plate internal fixation, utilize computer-aided to simulate reduction and internal fixa-tion as well as to design the internal fixation plate. The 3 D printing rapid prototyping technology titanium steel was used as the raw material to print steel plates implanted into body. The control group was given conventional open reduction and reconstruction plate fixation after internal fixation. The operation time, intraoperative blood loss, hospitalization time, fracture healing time, complication rate and surgical effect of 2 groups were observed. Results The operative time[（71.24 ± 18.27） minutes vs（93.54 ± 23.65） minutes], intraoperative blood loss[（81.05 ± 27.32） m L vs（114.62 ± 38.65） m L], hospitalization time[（15.17 ±3.26） days vs（18.24 ± 5.38） days] and fracture healing time[（63.24 ± 10.66） days vs（84.37 ± 12.08） days] of study group were statistically significantly lower than those of control group（P〈0.05）. The axial compression, torsion, and axial compression failure was no significant differences between 2 groups（P〈0.05）. The incidence of complications during the follow-up in study group was statistically significantly lower than that in control group（4.35 % vs 26.09 %; χ-2= 4.212, P〈0.05）. The excellent rate of study group was statistically significantly higher than that of control group（100.00 % vs 78.26 %;

关 键 词：股骨远端骨折 切开复位内固定 3D打印钢板 

分 类 号：R687.3[医药卫生—骨科学]