3D打印技术辅助手术治疗SchazkerⅤ、Ⅵ型胫骨平台骨折的初步应用  

Surgical treatment assisted by 3D printing technology for Schazker V andⅥtibial plateau fractures

作　　者：张峰[1] 李玮[1] 宋远征 张率功[1] 林峰[1] 沈冰[1] 王树方 Zhang Feng;Li Wei;Song Yuanzheng;Zhang Shuaigong;Lin Feng;Shen Bing;Wang Shufang(First Traumatic Department,Tengzhou Central People's Hospital,Jining Medical University,Tengzhou 277500,China)

机构地区：[1]济宁医学院附属滕州市中心人民医院创伤一科,滕州277599

出　　处：《国际医药卫生导报》2022年第21期3055-3059,共5页International Medicine and Health Guidance News

基　　金：济宁医学院实践教学教育科学研究课题(JYSJ2020B44)。

摘　　要：目的探讨3D打印技术辅助手术治疗Schazker V、VI型胫骨平台骨折的疗效。方法选择2020年1月至2021年1月入住滕州市中心人民医院的30例Schazker V、VI型胫骨平台骨折患者并随机分为两组。对照组15例,男7例、女8例,年龄(60.40±10.76)岁,采用传统手术治疗。观察组15例,男6例、女9例,年龄(53.40±17.82)岁,采用3D打印技术辅助手术治疗。评估两组患者的围手术期参数包括手术时间、失血量、术中透视次数、术中更换螺钉次数、骨折复位时间。统计学方法采用t检验、Fisher确切概率法或Free-man-Halton检验、秩和检验。结果观察组患者的手术时间、失血量、术中透视次数、术中更换螺钉次数、骨折复位时间均低于对照组(t=-10.729、-20.315、-10.837、-16.472、-6.153,均P<0.05)。两组患者住院时间、住院费用比较,差异均无统计学意义(t=-0.105、0.345,均P>0.05)。观察组患者术后X线片复位质量Rasmussen评分和末次随访膝关节HSS评分均高于对照组(z=-2.108、-2.320,均P<0.05)。观察组和对照组患者术后并发症发生率分别为6.7%(1/15)、46.7%(7/15),观察组术后并发症发生率小于对照组(P<0.05)。结论患者特定的3D打印模型提供了对胫骨平台骨折特征的全面了解,准确的针对患者进行个体化术前计划、术中指导及预测术中困难,从而优化了临床效果。Objective To explore the efficacy of 3D printing technology-assisted surgery in the treatment of Schazker V andⅥtibial plateau fractures.Methods A total of 30 patients with Schazker V andⅥtibial plateau fractures who were admitted to Tengzhou Central People's Hospital from January 2020 to January 2021 were selected and randomly divided into a control group and an observation group,with 15 cases in each group.There were 7 males and 8 females in the control group,and they were(60.40±10.76)years old.There were 6 males and 9 females in the observation group,and they were(53.40±17.82)years old.The control group were treated with traditional surgery,and the observation group with 3D printing technology-assisted surgery.The perioperative parameters,including operation duration,bleeding volume,number of fluoroscopy during operation,number of screw replacements during operation,and fracture reduction time,in the two groups were evaluated.The t test,Fisher's exact test or Free-man-Halton test,and rank sum test were applied.Results The operation duration,bleeding volume,number of fluoroscopy during operation,number of screw replacements during operation,and fracture reduction time in the observation group were lower than those in the control group(t=-10.729,-20.315,-10.837,-16.472,and-6.153;all P<0.05).There were no statistical differences in the hospitalization time and cost between these two groups(t=-0.105 and 0.345;P>0.05).The Rasmussen score and score of Hospital for Special Surgery(HSS)in the observation group were higher than those in the control group(z=-2.108 and-2.320;both P<0.05).The incidence of postoperative complications in the observation group was lower than that in the control group[6.7%(1/15)vs.46.7%(7/15)].Conclusion The patient-specific 3D printed model provides a comprehensive understanding of the characteristics of tibial plateau fractures,allowing accurate patient-specific preoperative planning,intraoperative guidance,and prediction of intraoperative difficulties,so it optimizes clinical outcome

关 键 词：胫骨平台骨折 Schazker V、VI型 3D打印 内固定 

分 类 号：R687.3[医药卫生—骨科学]