3D打印导向器辅助镜下ACL胫骨撕脱骨折固定  

3D printed guider assisted fixation of anterior cruciate ligament tibial avulsion fracture under arthroscope

作　　者：宋辰光 王鑫众 李晋 张利恒[2] 余家阔[3] 罗浩 玄峰学 SONG Chen-guang;WANG Xin-zhong;LI Jin;ZHANG Li-heng;YU Jia-kuo;LUO Hao;XUAN Feng-xue(Changchun University of Traditional Chinese Medicine,Changchun 130000,China;Sports Medicine Center,Peopled Hospital of Jilin Province,Changchun 130000,China;Sports Medicine Research Institute,Third Hospital,Peking University,Beijing 100083,China)

机构地区：[1]长春中医药大学,130000 [2]吉林省人民医院运动医学中心,130000 [3]北京大学第三医院运动医学研究所,100083

出　　处：《中国矫形外科杂志》2021年第12期1124-1127,共4页Orthopedic Journal of China

基　　金：吉林省卫生计生委资助课题(编号:2015z087)。

摘　　要：[目的]介绍3D打印辅助镜下前交叉韧带(anterior cruciate ligament, ACL)胫骨撕脱骨折固定的手术技术和初步临床结果。[方法] 2015年12月—2019年12月,采用3D打印导向器辅助镜下固定ACL胫骨撕脱骨折患者20例。按照术前CT扫描数据,建立伤膝3D模型,预演直接定位骨道位置,并设计打印相应的导向器。实际关节镜术中,采用3D打印导向器引导下建立骨道,引入缝线,对撕脱骨块编织复位固定。[结果]术后即刻所有患者前抽屉试验和Lachman试验均转为阴性,术中出血量(59.35±6.10) ml、手术操作时间(46.74±6.52) min、开始膝关节功能锻炼时间(39.69±2.55) d、骨折愈合时间(2.28±0.42) m。膝关节Lysholm评分由术前(40.26±3.15)显著提高至术后6个月(89.37±4.25)分(P<0.05)。[结论] 3D打印辅助镜下ACL胫骨撕脱骨折固定具有创伤小、精准性高、骨折块解剖复位、固定牢靠、操作时间及骨折愈合时间短等特点,患者术后关节功能恢复良好。[Objective] To introduce the surgical technique and preliminary clinical results of anterior cruciate ligament(ACL) tibial avulsion fracture fixed with the 3 D printed guider under arthroscope. [Methods] From December 2015 to December 2019, 20 patients received arthroscopic fixation of ACL tibial avulsion fracture with assistance of 3 D printed guider. According to the preoperative CT scanning data, a 3 D model of the injured knee was established, the position of the bone canal was directly positioned in the preview, and the corresponding guider was designed and printed. In the real arthroscopy, the bone tunnels were established under the guidance of the 3 D printed guide, sutures was introduced, and the avulsed bone blocks were braided and fixed. [Results] Both anterior drawer test and Lachman test became negative immediately postoperatively in all patients, with intraoperative blood loss of(59.35±6.10) ml, operation time of(46.7±6.5)min, the time to start knee functional exercise time of(39.69±2.55) days, and fracture healing time of(2.28±0.42) months. The Lysholm score significantly increased from(40.26±3.15) before operation to(89.37±4.25) at 6 months after operation(P<0.05). [Conclusion] This3 D printed guider assisted fixation of ACL tibial avulsion fracture under arthroscope has the advantages of small trauma, high accuracy, reliable anatomical reduction and fixation of the fracture, short operation time and fracture healing time, and good function recovery.

关 键 词：前交叉韧带 胫骨撕脱骨折 3D打印 

分 类 号：R683.42[医药卫生—骨科学]