3D打印导航模板辅助微创置钉在骨盆骨折合并髋臼骨折内固定术中应用的效果分析  

Effect analysis of 3D-printed guide plate assisted minimally invasive screw placement in internal fixation of pelvic fractures with acetabular fractures

作　　者：都芳涛[1] 康超 方继锋[1] 路新震 李兴晶[1] 侯耀鹏 李广义[1] DU Fang-tao;KANG Chao;FANG Ji-feng;LU Xin-zhen;LI Xing-jing;HOU Yao-peng;LI Guang-yi(Department of Orthopedic Trauma,Liaocheng Second People's Hospital(Liaocheng Second Afiliated Hospital of Shandong First Medical University),Liaocheng,Shandong 252600,China;不详)

机构地区：[1]聊城市第二人民医院(山东第一医科大学附属聊城二院)创伤骨科,山东252600 [2]聊城市第二人民医院(山东第一医科大学附属聊城二院)急诊外科,山东252600

出　　处：《中国骨与关节损伤杂志》2023年第2期118-121,共4页Chinese Journal of Bone and Joint Injury

摘　　要：目的观察3D打印个性化导航模板辅助微创置钉在骨盆骨折合并髋臼骨折内固定术中应用的可行性与效果。方法回顾性分析自2018-02—2020-03采用手术治疗的93例骨盆骨折合并髋臼骨折,其中45例术中采用3D打印个性化导航模板辅助微创置钉(3D打印组),48例术中在C型臂X线机透视辅助下徒手置钉(常规组)。比较两组手术时间、术中出血量、导针穿刺次数、术中X线透视次数,术后定期随访观察骨折愈合情况、髋关节功能恢复情况以及并发症发生情况。结果93例均获得随访,随访时间平均26.8(11~36)个月。所有患者骨折均愈合,未出现感染、骨折延迟愈合、骨折不愈合、内固定失效等并发症。与常规组比较,3D打印组手术时间更短,术中出血量更少,导针穿刺次数、术中X线透视次数也更少,而且末次随访时髋关节功能更优,差异有统计学意义(P<0.05)。结论与常规C型臂X线机透视辅助徒手置钉比较,3D打印个性化导航模板辅助微创置钉应用于骨盆骨折合并髋臼骨折手术中安全、有效,有助于减少导针穿刺次数与X线透视次数,进而缩短手术时间,同时可明显减少手术创伤,促进患者髋关节功能恢复。Objective To observe the feasibility and effect of 3D printing personalized guide plate assisted minimally invasive screw placement in internal fixation of pelvic fractures combined with acetabular fractures.Methods Ninety-three cases of pelvic fractures combined with acetabular fractures receiving surgical treatment from February 2018 to March 2020 were retrospectively analyzed.Among them,45 cases underwent minimally invasive screw placement assisted by 3D printing personalized guide plate(3D printing group),and 48 cases underwent bare-handed screw placement assisted by C-arm X-ray machine(conventional group).The operation time,intraoperative blood loss,number of guide needle puncture,and number of intraoperative X-ray fluoroscopy were compared between the two groups.Regular postoperative follow-up was conducted to observe fracture healing,hip functional recovery and complications.Results All the 93 cases were followed up for 11 to 36 months,with an average of 26.8 months.All fractures were healed without complications such as infection,delayed fracture union,fracture nonunion,and internal fixation failure.Compared with the conventional group,the 3D printing group had shorter operation time,less intraoperative blood loss,fewer guide needle puncture times and intraoperative X-ray fluoroscopy times,and better hip function at the last follow-up,with statistical significance(P<0.05).Conclusion Compared with the conventional C-arm Xray machine,3D printing personalized guide plate assisted minimally invasive screw placement is safe and effective in the operation of pelvic fractures combined with acetabular fractures,which is helpful to reduce the number of guide needle puncture and X-ray fluoroscopy times,thus shortening the operation time,and can significantly reduce surgical trauma and promote the recovery of hip joint function.

关 键 词：骨盆骨折 髋臼骨折 3D打印技术 个性化导航模板 微创置钉 内固定 

分 类 号：R687.3[医药卫生—骨科学]