3D打印联合导航治疗移位的Dennis Ⅰ、Ⅱ区骶骨骨折的效果观察  

The clinical effect of 3D printing combined with computer navigation technique in treating Dennis type Ⅰ and Ⅱ sacral fracture

作　　者：孙煜杰[1] 赫天 王新[1] SUN Yu-jie;HE Tian;WANG Xin(Department of Orthopedics Surgery,Yantai Yuhuangding Hospital Affiliated to Medical College)

机构地区：[1]青岛大学附属烟台毓璜顶医院创伤骨科,山东烟台264000

出　　处：《创伤外科杂志》2018年第12期892-895,共4页Journal of Traumatic Surgery

基　　金：烟台市科技计划项目资助(2015WS003)

摘　　要：目的探讨3D打印联合导航治疗移位的DennisⅠ、Ⅱ区骶骨骨折的效果。方法回顾性分析青岛大学附属烟台毓璜顶医院创伤骨科2013年12月—2016年3月,采用3D打印联合导航引导下的经皮骶髂螺钉固定术治疗DennisⅠ、Ⅱ区骶骨骨折患者12例,男性10例,女性2例;年龄19～55岁,平均30. 4岁。术前利用3D打印技术获得患者的骨折模型,初步了解伤侧骨盆的垂直移位和旋转移位情况模拟复位,为术中闭合复位提供指导。术中闭合复位成功后采取外固定架或克氏针临时固定,应用三维导航引导下完成骶髂螺钉的最终固定。结果术后对12例患者进行随访,时间2～12个月(平均4. 5个月)。骶骨骨折均达到临床愈合,无明显骨折再移位。其中2例术后出现骶髂关节处不适,予以取出骶髂螺钉。其中1例合并S1神经损伤者,行术中神经探查松解术后12个月神经症状恢复。结论对于DennisⅠ区和Ⅱ区的骶骨骨折,术前使用3D打印模型模拟复位,术中联合计算机导航辅助精确置入骶髂螺钉,可显著提高手术的成功率及准确率。Objective To evaluate the combination therapy of3D printing technique and computer navigation for treatment of Dennis typeⅠandⅡsacral fracture.Methods A retrospective analysis was conducted in12cases of sacral fracture who were admitted into our hospital from Dec.2013to Mar.2016and underwent percutaneous iliosacral screws fixation surgery with3D printing and computer navigation.There were10males and2females,with age ranging from19to55years(average,30.4years).Before surgery,pelvic fracture model was made with3D printing technique,and the vertical displacement and rotation displacement of the injured lateral pelvis were preliminarily explored,so as to simulate the reset and provide guidance for the closed reduction in operation.After successful closed reduction,the external fixator or the Kirsehner wire was temporarily fixed.The final fixation of the sacroiliac screw was completed with computer navigation(Medtronic Stealth Station S7).Results The12patients were followed up for2-12months(average,4.5months).The sacrum fractures were all clinically healed and no significant recurred fractures were found.Sacroiliac joint discomfort occurred in2cases,who were take out the sacroiliac screw.The sacral nerve injury occurred in1case,and the patient recovered12months after surgery.Conclusion For the sacral fracture of Dennis classification of typeⅠandⅡ,3D printing model and computer aided navigation can significantly increase the success rate and accuracy of surgery.

关 键 词：骶骨骨折 3D打印 计算机导航 

分 类 号：R683.2[医药卫生—骨科学]