3D打印技术辅助改良后内侧倒L入路切开复位内固定术治疗复杂胫骨平台骨折的疗效分析  

3D printing technique assisted by modified medial inverted L-incision open reduction and internal fixation in the treatment of complex tibial plateau fractures

作　　者：张擎柱[1] 万乾 张义[1] 付世杰[1] 李哲[1] 何志勇[1] 邱宇辰 金宇[1] 闫石[1] 杨小华[1] ZHANG Qingzhu;WAN Qian;ZHANG Yi;FU Shijie;LI Zhe;HE Zhiyong;QIU Yuchen;JIN Yu;YAN Shi;YANG Xiaohua(Department of Orthopedics,Affiliated Hospital of Chengde Medical College,Chengde 067000,China)

机构地区：[1]承德医学院附属医院创伤骨科,河北承德067000

出　　处：《中华实用诊断与治疗杂志》2018年第11期1091-1093,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：河北省科技计划项目(162777180)

摘　　要：目的探讨复杂胫骨平台骨折患者应用3D打印技术辅助改良后内侧倒L入路切开复位内固定术治疗的临床疗效及安全性。方法 41例复杂胫骨平台骨折患者根据治疗方式分为3D组18例和常规组23例,2组均行改良后内侧倒L入路切开复位内固定术。常规组术前行膝关节CT平扫,3D组在常规组基础上采用3D技术打印实体模型并在实体模型上模拟手术。比较2组手术时间、术中出血量、手术并发症发生率,以及术后第3天胫骨平台骨折复位放射学Rasmussen评分,术后12个月膝关节功能(hospital for special surgery,HSS)评分。结果 3D组手术时间[(127.3±11.7)min]较常规组[(167.4±15.8)min]短,术中出血量[(211.7±18.7)mL]较常规组[(291.6±25.3)mL]少,手术并发症发生率(5.55%)较常规组(26.08%)低,术后第3天Rasmussen评分及术后12个月HSS评分[(15.2±1.9)、(84.3±11.2)分]较常规组[(9.9±2.1)、(71.0±5.7)分]高(P<0.05)。结论复杂胫骨平台骨折患者行3D打印技术辅助改良后内侧倒L入路切开复位内固定术可缩短手术时间,减少术中出血量,提高骨折复位质量,改善膝关节功能,且并发症发生率低。Objective To investigate the clinical effect and safety of 3 Dprinting technique assisted by modified medial inverted L-incision open reduction and internal fixation in the treatment of complex tibial plateau fractures.Methods Forty-one patients with complex tibial plateau fractures were divided into 3 Dgroup（n=18）and conventional group（n=23）according to 3 Dprinting technique.Both two groups underwent modified posterior medial inverted L-incision open reduction and internal fixation.Conventional group underwent knee CT scan before operation.3 D group used 3 D technique to print the solid model on the basis of conventional group,and underwent simulated surgical operation on the solid model.The operative time,intraoperative blood loss,surgical complication incidence,the Rasmussen score of the tibial plateau fracture on the 3 rd postoperative day and hospital for special surgery（HSS）score were compared between two groups.Results The operative time was significantly shorter in 3 Dgroup（（127.3±11.7）min）,the intraoperative blood loss（（211.7±18.7）mL）was significantly less,the incidence of surgical complication（5.55%）was significantly lower,and the Rasmussen score on the 3 rd postoperative day and the HSS score in 12 months after surgery（15.2±1.9,84.3±11.2）were significantly higher in 3 Dgroup than those in conventional group（（167.4±15.8）min,（291.6±25.3）mL,26.08%,9.9±2.1,71.0±5.7）（P0.05）.Conclusion 3 Dprinting technique assisted by modified medial inverted L-incision open reduction and internal fixation can shorten the operative time,reduce the intraoperative blood loss,improve the quality of fracture reduction,restore effectively the knee joint function and reduce the complication incidence.

关 键 词：复杂胫骨平台骨折 3D打印技术 改良后内侧倒L入路切开复位内固定术 

分 类 号：R687.3[医药卫生—骨科学]