3D打印患手模型指导个性化选择皮瓣治疗虎口挛缩的效果研究  

3D printing the affected hand model to guide the individualized selection of flap in the treatment of contracture of the first web space

作　　者：郭礼平[1] 巨积辉[1] 周荣[1] 王健 余新水 Guo Liping;Ju Jihui;Zhou Rong;Wang Jian;Yu Xinshui(Department of Hand Surgery,Ruihua Affiliated Hospital of Soochow University,Suzhou 215104,Jiangsu Province)

机构地区：[1]苏州大学附属瑞华医院手外科,江苏苏州215104

出　　处：《中国临床解剖学杂志》2022年第2期221-224,共4页Chinese Journal of Clinical Anatomy

基　　金：江苏省青年医学人才项目(QNRC2016224)。

摘　　要：目的探讨利用3D打印患手模型指导个性化选择皮瓣治疗虎口挛缩的临床效果。方法自2018年3月至2019年10月,对10例虎口中~重度挛缩者,术前3D打印患手模型,依据模型设计虎口开大后创面的形状及面积,个性化选择合适的皮瓣修复创面,术中比对验证,术后随访观察治疗效果。结果术中发现创面形状及面积与术前模拟设计基本一致,皮瓣选择与术前模拟一致,10例皮瓣均成活,供区及受区创面Ⅰ期愈合,随访6~12个月,皮瓣外形满意,感觉部分恢复,拇指恢复外展及对掌功能,虎口角度增加50~60°(平均53.4°),虎口宽度增加18~35 mm(平均31.3 mm),虎口修复评定:优7例,良2例,中1例。结论术前3D打印患手模型可指导个性化的皮瓣,使虎口挛缩开大的创面达到精准修复,减少手术时间,术后虎口外形及功能恢复良好。Objective To investigate the clinical application of individualized skin flap in the treatment of contracture of first web space by 3D printing the model of the affected hand.Methods From March 2018 to October 2019,10 cases of moderate and severe contracture of first web space were treated with3D printing of the affected hand model before operation.The appropriate flaps were selected to repair the wound individualized according to the shape and area of the wound after opening the first web space of the model.Intraoperative comparison and verification,postoperative follow-up were performed to observe the treatment effect.Results The shape and area of the wound and the flap selection were basically in accordance with that of the preoperative simulation design.All the 10 cases of flaps survived,and the donor and recipient wound were healed at I stage.All flaps were followed up for 6~12 months.The appearance of the flaps was satisfactory,the sensation was partial recovered the abduction and opposition function of the thumb were restored.The angle of first web space increased by 50°-60°(with an average of 53.4°),and the width increased by 18 mm-35 mm(with an average of 31.3 mm).The repair evaluation of the first web space were excellent in 7 cases,good in 2 cases,medium in1 case.Conclusions The 3D printing of the affected hand model before operation can guide the individualized skin flap,so that the enlarged wound with contracture can be repaired accurately,the operation time can be reduced,and the shape and function of the first web space can be recovered well after operation.

关 键 词：3D打印 虎口挛缩 皮瓣 个性化 

分 类 号：R616.2[医药卫生—外科学] R628[医药卫生—临床医学]