采用3D打印技术辅助手术治疗复杂髋臼骨折效果分析  

The Effect of Surgery Assisted by 3D Printing Technique for Complex Acetabular Fractures

作　　者：张擎柱[1] 张义[1] 付世杰[2] 李哲[3] 何志勇[1] 邱宇辰 翟栋[1] 金宇[1] 闫石[1] 杨小华[1] ZHANG Qing-zhu;ZHANG Yi;FU Shi-jie;LI Zhe;HE Zhi-yong;QIU Yu-chen;ZHAI Dong;JIN Yu;YAN Shi;YANG Xiao-hua(Department of Orthopedics and Trauma, Affiliated Hospital of Chengde Medical College, Chengde, Hebei 067000, China;Department of Extremity Surgery, Affiliated Hospital of Chengde Medical College, Chengde, Hebei 067000, China;the First Department of Orthopaedic Spine Surgery, Affiliated Hospital of Chengde Medical College, Chengde, Hebei 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 [2]承德医学院附属医院手足外科,河北承德067000 [3]承德医学院附属医院脊柱外一科,河北承德067000

出　　处：《临床误诊误治》2018年第12期37-40,共4页Clinical Misdiagnosis & Mistherapy

基　　金：河北省科技计划项目(162777180)

摘　　要：目的探讨3D打印技术辅助手术治疗复杂髋臼骨折的临床效果。方法对我院2013年10月—2017年4月收治的行3D打印技术辅助手术治疗的复杂髋臼骨折32例进行回顾性分析。记录手术时间、术中出血量、围术期输血量、术中C型臂X线透视次数、术后术区引流量、并发症发生率等情况,采用Merle D'Aubignéand Postel评分评定骨折恢复情况,使用Matta评分评定骨折复位固定的影像学效果。结果本组手术时间(177. 0±51. 2) min,术中出血量(1150. 0±250. 6) ml,围术期输血量(880. 0±214. 9) ml,术中C型臂X线透视(8. 8±2. 1)次,术后术区引流量(329. 0±111. 7) ml。随访18. 5～22. 0个月,骨折均骨性愈合,手术结束至完全负重行走间隔3. 0～6. 5个月,平均3. 5个月。3例出现一过性医源性坐骨神经损伤,均于术后10 d～4周内完全恢复; 3例出现术后浅表感染,经换药处理l周后完全愈合。Merle D'Aubignéand Postel评分评定骨折恢复的临床效果为优7例,良13例,一般8例,差4例,优良率62. 5%; Matta评分评定骨折复位固定的影像学效果为优8例,良14例,一般6例,差4例,优良率68. 8%。结论 3D打印技术治疗复杂髋臼骨折的临床效果良好,有助于术者制定详细的术前规划,缩短手术时间,减少失血量,提高围术期安全性。Objective To investigate the clinical efficacy of surgery asissted by3D printing technique for complex acetabular fractures.Methods A retrospective analysis was performed on32patients with complex acetabular fractures who were treated with surgery assisted by3D printing techniques from October2013to April2017in Affiliated Hospital of Chengde Medical College.The duration of operation,intraoperative blood loss,perioperative blood transfusion volume,frequency of intraoperative C-arm fluoroscopy,postoperative drainage,and complications were recorded.Merle D'Aubignéand Postel scores were used to assess the clinical outcomes of acetabular fractures,and Matta scores were used to assess imaging findings of acetabular fractures.Results The duration of operation was(177.0±51.2)min in this group,and the intraoperative blood loss and the perioperative blood transfusion volume were(1150.0±250.6)ml and(880.0±214.9)ml respectively.In addition,frequency of intraoperative C-arm fluoroscopy was(8.8±2.1)times,and postoperative drainage volume was(329.0±111.7)ml.The patients in this group were followed up for18.5-22.0months.Bony union were obtained in all fractures.The intervals from surgery to full weight walking were3.0-6.5months,with a mean period of3.5months.Transient iatrogenic sciatic nerve injury occurred in3patients,and all the patients recovered completely after10d to4weeks.Superficial superficial infections occurred in3patients and all healed after one week of dressing change.At the last follow-up,Merle D'Aubignéand Postel scores were used to evaluate the clinical outcomes of acetabular fractures:excellent in7cases,good in13cases,fair in8cases,and poor in4cases.The excellent and good rate was62.5%.At the final follow-up,Matta score was used to evaluate the imaging findings of acetabular fractures:excellent in8cases,good in14,fair in6,and poor in4,with an excellent and good rate of68.8%.Conclusion The application of3D printing technique to the treatment of complex acetabular fractures is clinically feasible.It can he

关 键 词：髋骨折 髋臼 3D打印技术 

分 类 号：R681.6[医药卫生—骨科学]