3D打印结合腹直肌外侧入路治疗骨盆髋臼骨折疗效观察  

Application of 3D Printing Technology Combined with Lateral Rectus Abdominis Approach in the Treatment of Pelvic and Acetabular Fractures

作　　者：成本强[1] 苏晓恩[1] 罗瑞文[1] 卢向莉[1] Cheng Benqiang;Su Xiaoen;Luo Ruiwen(Department of Orthopaedics,1st People's Hospital of Zhaoqing,Zhaoqing 526040,China)

机构地区：[1]肇庆市第一人民医院创伤骨外科,广东肇庆526040

出　　处：《实用骨科杂志》2021年第1期10-13,26,共5页Journal of Practical Orthopaedics

基　　金：2016年肇庆市科技创新计划项目(2016040307)。

摘　　要：目的比较3D打印技术结合腹直肌外侧入路和髂腹股沟入路手术治疗骨盆和髋臼骨折的临床效果。方法回顾性分析2014年1月至2017年12月手术治疗并获得随访的50例骨盆和髋臼骨折患者资料,其中3D打印技术结合腹直肌外侧入路组23例,髂腹股沟入路组27例,比较两组的临床疗效。临床疗效评估包括切口长度、出血量、术中X线曝光次数、手术时间、并发症发生率、骨折复位优良率、术后髋关节功能评分。结果患者获得18~41个月随访,平均随访时间(24.62±6.21)个月。腹直肌外侧入路组和髂腹股沟入路组的切口长度、出血量、X线曝光次数、手术时间、并发症发生率、骨折复位优良率、髋关节功能优良率分别为(10.52±3.19)cm和(20.85±4.61)cm、(527.74±130.68)mL和(655.89±110.4)mL、(4.83±1.59)次和(6.96±1.97)次、(220.04±30.73)min和(254.04±26.98)min、8.6%和33.3%、91.3%和62.9%、95.7%和66.7%,两组比较差异有统计学意义(P<0.05)。腹直肌外侧入路组明显优于髂腹股沟入路组。结论经腹直肌外侧入路手术治疗骨盆及髋臼骨折,术野显露清晰,结合3D打印技术复位和固定骨折方便,创伤少、安全性高、手术效果良好,学习曲线短,建议在临床推广应用。Objective To compare the clinical effects in the treatment of pelvic and acetabular fractures by using 3D printing technology combined with lateral rectus abdominis approach and ilioinguinal approach.Methods We conducted a retrospective analysis of 50 cases of pelvic and acetabular fractures who underwent surgical treatment from January 2014 to December 2017.The patientsincluded a study group of 23 cases treated with 3D printing technology combined with the lateral rectus approach and a control group of 27 cases with the ilioinguinal approach.Eventually,the curative effects of these two groups were analyzed and compared base on the clinical evaluation including the length of the incision,the amount of bleeding,the number of X-ray exposures during the operation,the operation time,the incidence rate of complications,the excellent rate of fracture reduction,and the postoperative hip joint function score.Results All patients were followed up for 18 to 41 months,with an average of(24.62±6.21)months.In the study group and the control group,the length of the incision were respectively(10.52±3.19)cm and(20.85±4.61)cm,the amount of bleeding were respectively(527.74±130.68)mL and(655.89±110.4)mL,the number of X-ray exposures were respectively(4.83±1.59)times and(6.96±1.97)times,the operation time were respectively(220.04±30.73)min and(254.04±26.98)min,the incidence rate of complications were respectively 8.6%and 33.3%,the rate of excellent fracture reduction were respectively 91.3%and 62.9%,and the rate of excellent hip function were respectively 95.7%and 66.7%.The difference between the two groups was statistically significant P<0.05 and the results of study group was significantly better than the control group.Conclusion By applying 3D printing technology combined with the lateral rectus abdominis approach,the patients'pelvic and acetabular fractures are exposed clearly during the surgery.This application is convenient for reduction and fixation and holding the benefit of less trauma,higher safety,better operati

关 键 词：3D打印技术 骨盆骨折 髋臼骨折 腹直肌外侧入路 髂腹股沟入路 

分 类 号：R683.3[医药卫生—骨科学]