3D打印辅助治疗SandersⅢ、Ⅳ型跟骨骨折的临床研究  

The Clinical Research of 3D Printing Technology assisted Surgical Treatment of Sanders Ⅲ、Ⅳ type calcaneal fracture

作　　者：陈劲[1] 赵宁[1] 李建炜[1] 阮国强[1] 梁波[1] CHEN Jin;ZHAO Ning;LI Jian-wei(Zhanjiang center people's hospital,Zip code,524000)

机构地区：[1]湛江中心人民医院,广东湛江524000

出　　处：《中国伤残医学》2020年第19期7-9,共3页Chinese Journal of Trauma and Disability Medicine

摘　　要：目的:分析3D打印技术辅助手术治疗SandersⅢ、IV型复杂跟骨骨折的临床疗效.方法:统计2016年10月-2018年11月,湛江中心人民医院收治的48例跟骨粉碎性骨折患者资料,男30例,女18例.年龄20-65岁.根据跟骨的CT平扫骨重建影像进行Sanders分型:III型28例、IV型20例.所有患者均为新鲜闭合性骨折,采用切开复位钢板、螺钉内固定术治疗.将资料随机分为2组,观察组术前使用Mimics软件处理骨折CT扫描数据后打印与实体比例相同的跟骨骨折模型,根据骨折模型模拟手术,选择合适的手术入路、复位方法及内固定钢板、螺钉.对照组行传统手术治疗.分别记录2组手术时间、术后3天及12个月跟骨长度、宽度、Bohler角度、Gissane角度、术后12个月踝关节功能评分(踝关节Kofoed评分标准).结果:48例患者随访时间均超过12个月,观察组手术切口均甲级愈合,对照组2例术后手术切口渗液,1例手术切口周围肿胀,肤色淤紫,经间断拆线,切口换药后愈合.观察组与对照组手术时间分别为(61±10)分钟、(122±26)分钟;观察组与对照组相比手术时间明显缩短,差异有统计学意义(P<0.05);观察组与对照组术后12个月后Kofode评分为(92.3±6.5)分、(90.1±8.1)分;2组对比差异无统计学意义(P>0.05).观察组与对照组术后3天及术后12个月跟骨高度、宽度、Bohler角度、Gissane角度变化无明显差异(P>0.05).结论:3D打印辅助手术治疗跟骨关节内复杂骨折可明显缩短手术时间,减少手术切口愈合不良可能,术后功能恢复良好,疗效确切,值得在临床中推广应用.Objective:To analyze the clinical efficacy of 3D printing technology assisted surgical treatment of Sanders Ⅲ、Ⅳ type calcaneal fracture.Methods:objective Statistics from October 2016 to November 2018,The data of 48 patients with comminuted fractures of the calcaneus With admitted by Zhanjiang Center people's hospital,30 males and 18 females.Age from 20 to 65 years old.Sanders classification based on CT reconstruction of the calcaneus:Type Ⅲ 28 cases、Type Ⅳ 20 cases.All Calcaneal fractures were fresh and closed.Treatment with open operation by plate and screw internal fixation.Randomly divide the data into two groups.Preoperative use of Mimics software to process fracture CT scan data and print the same calcaneal fracture model with the same physical ratio,in the experimental group.The Simulated surgery according to fracture model.Choosing the right surgical approach,Resetting method and plate、screw.Using the Traditional surgical operation in control group.To record the operation time,calcaneal length、calcaneal width、calcaneal Bohler angle、calcaneal Gissane angle on the 3rd day and 12th month after surgery and the ankle joint function score(Ankle Kofoed score)12 months after surgery.Results:The follow-up time of 48 patients were more than 12 months,All surgical incisions Grade A healing in test group.2 cases of surgical incision exudate in control group,1 case surgical incision swelling,The skin near incision were purple,The Incision healing by Intermittent disconnection,Dressing change.The operation time of experimental group and control group(61±10)min、(122±26)min;The difference is statistically significant(P<0.05).The change of the calcaneal length、calcaneal width、calcaneal Bohler angle、calcaneal Gissane angle on the 3rd day and 12th month after surgery and the ankle joint function score(Ankle Kofoed score)12 months after surgery are no significant difference(P>0.05).Conclusion:3D printing technology assisted surgical treatment of Sanders Ⅲ、Ⅳ type calcaneal fracture Can signi

关 键 词：跟骨骨折 3D打印 Sanders分型 内固定术 

分 类 号：R683.42[医药卫生—骨科学]