3D打印技术结合虚拟复位在鼻-眶-筛粉碎性骨折整复中的应用研究  

Study on application of 3D printing technology combined with virtual reduction in the treatment of comminuted fracture of naso-orbital-ethmoid

作　　者：刘宁宁[1] 王冰[2] LIU Ning-ning;WANG Bing(Department of Oral and Miailfacial Oncology Surgery,The First Afiliated Hospital of Xinjiang Medical University,Urumqi 830011,China)

机构地区：[1]新疆医科大学第一附属医院(附属口腔医院)口腔修复科,新疆乌鲁木齐830011 [2]新疆医科大学第一附属医院(附属口腔医院)颌面肿瘤外科,新疆乌鲁木齐830011

出　　处：《中国美容整形外科杂志》2021年第1期49-52,I0016,共5页Chinese Journal of Aesthetic and Plastic Surgery

基　　金：新疆维吾尔自治区卫生健康青年医学科技人才专项科研项目(WJWY-201924)。

摘　　要：目的将3D打印技术应用在颌面部鼻-眶-筛粉碎性骨折整复手术中,探寻数字化外科在鼻-眶-筛复合骨折手术复位过程中的准确性及优势。方法选取2017—2019年新疆医科大学第一附属医院收治的鼻-眶-筛粉碎性骨折患者17例。术前完成数据采集,根据DICOM软件数据进行患者头面部骨性解剖的3D虚拟重建,并同期完成虚拟复位,将虚拟复位后的模型在体外坚固内固定,置入钛板钛钉,在正式进行手术复位时以其作为手术复位的标准,指导手术。并通过术前与术后模型匹配,检验手术效果。结果本组17例患者均顺利完成手术,术中结合术前虚拟复位标准进行了精准复位,与健侧数据进行对比,内眦间距、内眦鼻背矢状高度、鼻根指数、视觉模拟评分等检测数据均得到良好改善(P<0.05)。患者术后面部外形改善明显,复位效果较满意。结论在3D打印技术支持下,通过术前采集测量、虚拟复位、术前预弯、术中指导等技术,极大地提高了鼻-眶-筛复合骨折术中复位的精准性。因本术式缩短了手术时间,故很大程度上减少了并发症的发生,值得临床开展应用。Objective The 3 D printing technology was applied in the reduction of comminuted fracture of naso-orbital-ethmoid. To explore the accuracy and advantage of digital surgery in the reduction process of naso-orbital-ethmoid complex fracture.Methods From 2017 to 2019, 17 patients with comminuted fracture of naso-orbital-ethmoid were collected in the Department of Oral and Maxillofacial Surgery of The First Affiliated Hospital of Xinjiang Medical University. The data collection was completed before the operation, and the 3 D virtual reconstruction of head and face bone anatomy was performed according to DICOM software data. The virtual reduction was completed during the same period. The model after virtual reduction was fixed firmly in vitro, the titanium plate and titanium nail were implanted. When the operation was officially performed, it was used as the standard of surgical reduction to guide the operation.The efficacy of operation was evaluated by matching the preoperative and postoperative model. Results The operation was successfully completed in 17 patients. The intraoperative virtual reduction standards were combined to carry out accurate reduction. Compared with the data of the healthy side, the measurement data of the distance between the inner canthus, the sagittal height of the inner canthus and the bridge of the nose, the index of the nasal root and the visual analogue scale(VAS) were well improved(P<0.05). The postoperative appearance of the face was significantly improved and the efficacy of reduction was satisfactory. Conclusion Under the support of 3 D printing technology, the technologies such as preoperative collection and measurement, virtual reduction, preoperative pre-bending and intraoperative guidance have greatly improved the accuracy of intraoperative reduction of naso-orbital-ethmoid fracture. The operation time is reduced and the incidence of complications is decreased to a great extent. It is should be considerable for clinical application.

关 键 词：鼻-眶-筛骨折 虚拟复位 粉碎性骨折 3D打印技术 

分 类 号：R622[医药卫生—整形外科]