3D打印辅助截骨矫正陈旧性膝周围骨折畸形  

3D printing assisted osteotomy for correction of deformities secondary to peri-knee fractures

作　　者：刘军廷[1] 苏伟[1] 贝涛[1] 吴家恒 郭宸 冯迪森 赵劲民[1,2,3] LIU Jun-ting;SU Wei;BEI Tao;WU Jia-heng;GUO Chen;FENG Di-sen;ZHAO Jin-min(Department of Traumatology and Orthopedics,The First Affiliated Hospital;Center for Regenerative Medicine;Collaborative Innovation Center,Guangxi Medical University,Nanning 530021,China)

机构地区：[1]广西医科大学第一附属医院创伤骨科手外科 [2]广西医科大学再生医学中心 [3]广西医科大学协同创新中心,广西南宁530021

出　　处：《中国矫形外科杂志》2021年第18期1688-1691,共4页Orthopedic Journal of China

基　　金：广西科技基地和人才专项项目(编号:桂科AD17129012);广西大学生创新创业训练计划项目(编号:201910598010);广西医科大学长寿与老年相关疾病教育部重点实验室开放课题(编号:KLLAD201907)。

摘　　要：[目的]介绍3D打印辅助截骨矫正陈旧性膝周围骨折畸形的手术技术和初步临床结果。[方法] 2015年9月—2018年9月本科收治陈旧性膝周围骨折畸形患者16例,依据术前3D打印膝部骨关节模型,制定个体化的截骨计划。术中按计划截骨,矫正恢复下肢力线,恢复关节面平整和关节稳定,并用内固定或外固定截骨断端。骨延长或骨搬移矫正下肢不等长或骨缺损,软组织松解术矫正关节挛缩。[结果]随访时间12~24个月,平均(16.19±3.24)个月。KSS评分由术前(29.63±6.50)分,显著增加至末次随访时(62.19±6.93)分;膝关节活动度(range of motion, ROM)由术前(9.38±4.63)°,显著增加至末次随访时(63.44±10.03)°;双侧肢体长度差由术前的(3.81±1.64) cm,显著减少至末次随访时(1.38±1.03) cm。[结论] 3D打印辅助截骨成功矫正陈旧性膝周围骨折畸形,术前规划精准,提高了手术效率。[Objective] To introduce the surgical technique and preliminary clinical results of 3D printing assisted osteotomy for correction of deformities secondary to peri-knee fractures. [Methods] From September 2015 to September 2018, 16 patients underwent abovesaid surgical procedures for deformities secondary to peri-knee fractures in our department. Before operation individualized osteotomy plans were developed according to 3D printed real models of knee complex. During the real surgical procedure, osteotomy was conducted based on the individual plan to correct the alignment of lower limbs and restore joint congruity, and stabilized by internal or external fixation. If necessary, bone lengthening or bone transportation was added to correct limb length discrepancy or bone defect. Additionally, soft tissue release was conducted to correct myofascial contracture. [Results] The 16 patients resumed full weight-bearing activities from 12 to 18 weeks, with an average of(16.19±3.24) weeks after operation. The KSS score increased from(29.63±6.50) preoperatively to(62.19±6.93) at the latest follow-up. The range of motion(ROM) of the knee joint increased significantly from(9.38±4.63) ° preoperatively to(63.44±10.03) ° at the last follow-up, However, the bilateral limb length difference was significantly reduced from(3.81±1.64) cm before surgery to(1.38±1.03) cm at the latest follow-up. [Conclusion] The 3D printing assisted osteotomy successfully corrects the old peri-knee fracture deformities with advantages of accurate individual plan and high efficiency of surgical operation.

关 键 词：膝 骨折 畸形 3D打印 截骨 

分 类 号：R683.42[医药卫生—骨科学]