虚拟手术设计结合3D打印在复杂髋臼骨折治疗中的应用  

Application of virtual surgery design combined with 3D printing in the treatment of complex acetabular fractures

作　　者：朱海泉[1] 尚修超 孟祥圣[1] 刘子敏[1] 井晟 孙晓[1] Zhu Haiquan;Shang Xiuchao;Meng Xiangsheng;Liu Zimin;Jing Sheng;Sun Xiao(Department of Emergency Surgery,Lianyungang First People's Hospital,Lianyungang,Jiangsu 222002,China)

机构地区：[1]连云港市第一人民医院急诊外科,江苏连云港222002

出　　处：《创伤外科杂志》2022年第1期52-56,共5页Journal of Traumatic Surgery

基　　金：连云港市卫生科技项目(ZD1901)。

摘　　要：目的探讨虚拟手术设计结合3D打印在复杂髋臼骨折治疗中的应用。方法回顾性分析连云港市第一人民医院急诊外科2017年2月—2020年2月收治的复杂髋臼骨折患者80例,男性47例,女性33例;年龄27~62岁,平均44.0岁。按照手术方法不同分为3D组(36例)和常规组(44例),常规组行传统方法切开复位钢板内固定;3D组为3D打印结合术前虚拟手术设计,钢板预成型进行切开复位钢板内固定。比较两组患者手术、骨折复位、髋关节功能恢复、并发症发生情况。结果3D组术中出血量、手术时间、术中透视次数、住院时间少于常规组(618.7±113.6)mL vs.(839.4±195.7)mL、(3.3±0.5)h vs.(4.1±0.7)h、(7.0±1.3)次vs.(10.5±2.7)次、(13.6±2.1)d vs.(15.7±3.4)d,P<0.05,3D组术后引流量少于常规组(309.9±37.6)mL vs.(321.4±44.1)mL,P>0.05;3D组骨折复位优良率优于常规组(92%vs.73%),术后6个月髋关节功能优良率优于常规组(94%vs.77%),P<0.05;3D组并发症发生率14%(异位骨化2例、骨神经牵拉1例、切口感染1例、创伤性关节炎1例),常规组并发症发生率18%(异位骨化3例、骨神经牵拉2例、切口感染1例、创伤性关节炎2例),两组比较差异无统计学意义(P>0.05)。结论复杂髋臼骨折的治疗中,虚拟手术设计结合3D打印能减少术中出血量,缩短手术时间,避免术中多次透视,有利于骨折复位,促进恢复髋关节功能恢复。Objective To explore the application of virtual surgery design combined with 3D printing in the treatment of complex acetabular fractures.Methods A retrospective analysis was performed on 80 patients with complex acetabular fractures admitted to Department of Emergency Surgery,Lianyungang First People's Hospital between Feb.2017 and Feb.2020.There were 47 males and 33 females,with an average age of 44.0 years(range,27-62 years).According to different surgical methods,they were divided into 3D group(36 cases,virtual surgery design combined with 3D printing)and routine group(44 cases,routine surgery).The surgical status,fracture reduction,recovery of hip function and complications between the two groups were compared.Results The intraoperative blood loss,operation time,times of intraoperative fluoroscopy and hospitalization time in the 3D group were less than those in the routine group[(618.7±113.6)mL vs.(839.4±195.7)mL,(3.3±0.5)hours vs.(4.1±0.7)hours,(7.0±1.3)times vs.(10.5±2.7)times,(13.6±2.1)days vs.(15.7±3.4)days,P<0.05],and postoperative drainage volume was less than that in the routine group[(309.9±37.6)mL vs.(321.4±44.1)mL,P>0.05].The excellent and good rate of fracture reduction was better in the 3D group than that of the routine group(92%vs.73%),and the excellent and good rate of hip function was better in the 3D group than that of the routine group at 6 months after surgery(94%vs.77%,P<0.05).The difference in the incidence of complications between 3D group(2 cases with heterotopic ossification,1 case with bone nerve traction,1 case with incision infection,1 case with traumatic arthritis)and routine group(3 cases with heterotopic ossification,2 cases with bone nerve traction,1 case with incision infection,2 cases with traumatic arthritis)was not statistically significant(14%vs.18%,P>0.05).Conclusion The application of virtual surgery design combined with 3D printing in the treatment of complex acetabular fractures can reduce intraoperative blood loss,shorten operation time and avoid intraoperati

关 键 词：复杂髋臼骨折 虚拟手术设计 3D打印 髋关节功能 骨折复位 

分 类 号：R683.3[医药卫生—骨科学]