3D打印模型与CT三维重建影像辅助手术治疗复杂髋臼骨折的疗效  

Comparison of 3D printing model and three-dimensional reconstruction of CT scan images in the treatment of complex acetabular fractures

作　　者：强廷会[1] 赵家瑞 牟欢[1] 郭忠尚 杜兴国[1] 薛超[1] 周新立[1] Qiang Tinghui;Zhao Jiarui;Mu Huan;Guo Zhongshang;Du Xingguo;Xue Chao;Zhou Xinli(Department of Bone and Joint Surgery,Hanzhong Central Hospital,Hanzhong,Shaanxi 723100,China)

机构地区：[1]汉中市中心医院骨关节外科,陕西汉中723100

出　　处：《创伤外科杂志》2022年第2期107-111,共5页Journal of Traumatic Surgery

摘　　要：目的探讨使用骨折3D打印模型辅助手术与参考骨折处CT三维重建影像辅助手术治疗复杂髋臼骨折的疗效。方法回顾性分析2017年10月—2020年9月汉中市中心医院骨关节外科手术治疗复杂髋臼骨折患者60例,男性36例,女性24例;年龄25~64岁,平均41.8岁。根据是否使用3D打印模型分为3D组(34例)及对照组(26例)。3D组术前应用3D打印模型进行术前计划、预手术复位及钢板体外塑型,男性20例,女性14例;年龄25~64岁,平均41.2岁;道路交通伤20例,高处坠落伤11例,砸伤3例。对照组未使用3D打印技术,术前计划及术中均参考CT三位重建影像实施术前规划及手术治疗,男性16例,女性10例;年龄26~55岁,平均42.6岁;道路交通伤17例,高处坠落伤7例,砸伤2例。比较两组患者手术时间、术中出血量、术中术后输血量、术中透视次数、Matta评分、Merle D'Aubigne&Postel评分情况。结果3D组平均手术时间、术中透视次数、术中出血量及术中术后输血量较对照组显著减少(227.3±31.3)min vs.(280.8±26.8)min、(8.0±1.7)次vs.(9.9±1.7)次、(835.3±174.3)mL vs.(1094.2±163.3)mL、(4.3±1.2)IU vs.(5.1±1.1)IU,P<0.05;患者均获得12~30个月随访,平均18.0个月,末次随访时3D组与对照组Merle D'Aubigne&Postel评分优良率、髋臼骨折影像学Matta评分优良率比较差异无统计学意义(76.47%vs.80.77%、76.47%vs.76.92%,P>0.05)。结论应用骨折3D打印模型辅助手术治疗复杂髋臼骨折可缩短手术时间,减少术中出血及透视次数,可以提高手术安全性。Objective To compare the effect of 3D printing fracture model assisted surgery and three-dimensional reconstruction assisted surgery with reference of CT scan images of the fracture site in the treatment of complex acetabular fractures.Methods This study retrospectively analyzed 60 patients with complex acetabular fractures treated in our hospital from Oct.2017 to Sep.2020.There were 36 males and 24 females,aged from 25 to 64 years,with an average of 41.8 years.They were divided into 3D group(34 cases)and control group(26 cases)according to whether 3D printing model was used or not.In the 3D group,the 3D printing model was used for preoperative planning,pre-surgical reduction and plate in-vitro shaping.There were 20 males and 14 females;the age ranged from 25 to 64 years,with an average of 41.2 years;causes of injury:traffic injury in 20 cases,falling injury in 11 cases and smashing injury in 3 cases.The conventional group did not use 3D printing technology,preoperative planning and surgical treatment were carried out with reference to three-dimensional reconstruction of CT scan images.There were 16 males and 10 females;the age ranged from 26 to 55 years,with an average of 42.6 years;causes of injury:traffic injury in 17 cases,falling injury in 7 cases and smashing injury in 2 cases.The operation time,intraoperative blood loss,intraoperative and postoperative blood transfusion,intraoperative fluoroscopy times,Matta score,Merle D'Aubigne&Postel score were compared.Results The average operation time,intraoperative fluoroscopy times,intraoperative blood loss and intraoperative and postoperative blood transfusion of 3D group were significantly less than those of conventional group[(227.3±31.3)minutes vs.(280.8±26.8)minutes,(8.0±1.7)times vs.(9.9±1.7)times,(835.3±174.3)mL vs.(1094.2±163.3)mL,(4.3±1.2)IU vs.(5.1±1.1)IU,P<0.05];All patients were followed up for 12-30 months,with an average of 18.0 months.At the last follow-up,there was no significant difference in Matta score and Merle D’Aubigne&Postel score(7

关 键 词：髋臼骨折 3D打印 三维重建 

分 类 号：R687.3[医药卫生—骨科学]