基于3D打印技术辅助治疗胫骨远端粉碎性骨折  

Adjuvant treatment for comminuted fractures of distal tibia based on 3D printing technique

作　　者：张文举[1] 滕勇[2] 季明华 郭树章[2] 李强[2] 范相成 ZHANG Wen-ju;TENG- Yong;JI Ming-hua(Department of ankle, Sichuan Provincial Orthopedic Hospital, Chengdu 610000, China)

机构地区：[1]四川省骨科医院足踝外科,四川成都610000 [2]新疆军区总医院创伤骨科,新疆乌鲁木齐830001

出　　处：《中国医学装备》2017年第12期60-64,共5页China Medical Equipment

基　　金：国家自然科学基金(31360229)"基于3D打印技术的结构性人工骨仿生优化设计与制备"

摘　　要：目的:探讨三维(3D)打印技术在辅助治疗胫骨远端粉碎性骨折的临床疗效。方法:选取24例临床胫骨远端粉碎性骨折患者,将其按照数表法随机分为观察组(10例)和对照组(14例);所有患者均行双下肢血管彩超检查,并行踝关节CT扫描。观察组以医学数字成像及通信(DICOM)格式输出,经Mminics软件处理,转换数据为立体光刻(STL)格式输入3D打印机,制作出与胫骨远端实体比例为1∶1的骨折模型,制定整复及内固定方案;对照组按常规方法行切开复位内固定术。记录两组患者手术时间、术中出血量和骨折复位情况,采用Burwell-Charnley评价标准对骨折复位程度进行评价;采用Olerud-Molander踝关节功能主观评分标准,分别评价患者术后12个月踝关节功能恢复情况。结果:观察组手术时间、出血量明显优于对照组,其差异有统计学意义(t=14.851,t=26.427;P<0.05);对两组患者进行随访,术后12个月观察组患者OlerudMolander踝关节功能评分与对照组比较,差异无统计学意义(t=0.791,P>0.05)。结论:应用3D打印技术辅助治疗胫骨远端粉碎性骨折较传统手术具有明显优势,是治疗胫骨远端粉碎性骨折的有效方法。Objective:To investigate the clinical efficacy of3D printing technique in the treatment of comminuted fractures of distal tibia.Methods:24patients with comminuted fractures of distal tibia were divided into observation group(10cases)and control group(14cases)as the random number table.All of patients underwent vascular ultrasound examination of both lower extremities and CT scan of ankle.The results of observation group were output by using medical digital image and communication format(DICOM),and then they were processed by using Minics software.After these data were transformed to STL format,they were input in3D printer to produce fracture model that was1:1with the distal tibia.Based on above information,the restitution and internal fixation scheme were formulated.The patients of control group received internal fixation of open reduction as routine methods.The operation time,the intra-operative bleeding amount and reduction of fracture were recorded and Burwell-Charnley evaluation criteria was applied to evaluate reduction of fracture.Besides,the function recovery of ankle at postoperative12months were evaluated by using Olerud-Molander ankle function subjective scoring criteria.Results:The operation time and bleeding amount of observation group was significantly better than that of control group(t=14.851,t=26.427,P<0.05).As the results of follow up,the difference of Olerud-Molander ankle function scoring between observation group and control group was no significant(t=0.791,P>0.05).Conclusion:The adjuvant treatment of3D printing technique for distal tibia comminuted fractures has obvious advantages compared with traditional operation.It is an effective method for the comminuted fractures of distal tibia.

关 键 词：胫骨远端骨折 3D打印 切开复位 模拟手术 

分 类 号：R681.8[医药卫生—骨科学]