3D打印技术辅助术前设计和重建肘关节解剖结构1例报告及文献复习  

3D printing technology-assisted pre-operative design and reconstruction of elbow joint anatomy structure:A case report and literature review

作　　者：吴乃超 韩青[1] 李珊 陈炳鹏[1] 张奥博 刘旸 王金成[1] WU Naichao;HAN Qing;LI Shan;CHEN Bingpeng;ZHANG Aobo;LIU Yang;WANG Jincheng(Department of Orthopedics,Second Hospital,Jilin University,Changchun 130041,China;Department of Dermatology&STD,Second Hospital,Jilin University,Changchun 130041,China)

机构地区：[1]吉林大学第二医院关节外科,吉林长春130041 [2]吉林大学第二医院皮肤性病科,吉林长春130041

出　　处：《吉林大学学报（医学版）》2019年第6期1422-1426,I0020,共6页Journal of Jilin University：Medicine Edition

基　　金：国家自然科学基金资助课题(81802174);吉林省科技厅科技专项基金资助课题(20170204004X,20180520115JH)

摘　　要：目的:探讨通过3D打印技术辅助进行术前设计指导实施个性化定制肘关节假体置换术的可行性。方法:收治1例右肱骨远端粉碎性骨折术后患者,10年前因摔伤导致肱骨髁粉碎性骨折行切开复位内固定治疗,治疗后因内固定物断裂失效,关节强直及疼痛,活动受限,来本院行肘关节功能重建和缓解疼痛,给予患者3D打印辅助个性化定制肘关节假体置换术治疗,术前通过计算机辅助设计技术联合3D打印技术进行术前设计,模仿重建解剖形态确定截骨范围,以重建解剖形态为基础设计个性化肘关节假体。术中按照术前设计进行截骨并行肘关节重建术。结果:患者手术顺利完成,术中定位显示肘关节假体位置良好,达到术前设计效果,术后随访结果满意,术后6个月患者的关节功能能够满足日常生活行为需要;术后36个月随访肘关节功能评价(HSS)评分由术前的15分恢复为90分。结论:对于复杂的肱骨远端骨折内固定物断裂的患者,可采用计算机辅助设计技术结合3D打印技术进行假体设计和辅助术前设计,实现患者肘关节解剖结构重建及功能恢复。Objective:To investigate the feasiblity of 3DPrinting technology-assistedPre-operative design in guiding thePerformance of individualized customization elbow jointProsthesis replacement.Methods:A malePatient with comminuted fracture of the right distal humerus after operation was selected,the comminuted fracture of the distal humerus was treated with open reduction and internal fixation 10 years ago.Because of internal fixation fracture,the joint appeared stiffness andPain,and the activity was restricted after treatment;thePatient was admitted to hospital for elbow joint function recovery andPain relief,and thePatient was given the 3DPrinting technology-assisted individualized customization elbow jointProsthesis replacement.The computer-assisted design technique combined with 3DPrinting technology was used to simulate the reconstruted anatomly morphology to confirm the osteotomy range;thePersonalized elbowProsthesis was designed based on the reconstructed anatomy morphology.During the operation,the osteotomy and elbow joint reconstruction werePerformed according to the design.Results:The operation was successfully completed,and the intraoperativePositioning results showed that the elbow jointProsthesis was in goodPosition and achieved thePreoperative design effect.ThePostoperative follow-up result was satisfactory,the activity of elbow joint could satisfy the daily needs of thePatient 6 months after operation.Thirty-six months after operation,the HSS score was increased from 15Points before operation to 90Points after operation.Conclusion:For thePatients with internal fixation fracture after complicated distal humerus fracture,the computer-aided design technique combined with 3DPrinting technology can be used to assist theProsthesis design andPreoperative design,and the elbow joint anatomy can be reconstructed and the function can be restored by this method.

关 键 词：肱骨远端骨折 内固定物断裂 3D打印技术 个性化定制 肘关节置换 

分 类 号：R684.7[医药卫生—骨科学]