3D打印技术辅助陈旧性骨盆髋臼骨折的手术治疗  

3D Printing Technology Assisted the Surgical Treatment of Obsolete Pelvic and Acetabular Fractures.

作　　者：李振宏[1] 韦进强[1] 梁周 李建全 梁静然 郭沂[1] 吕广桂 李瑞[1] 易成腊[2] LI Zhen-hong;WEI Jin-qiang;LIANG Zhou;LI Jian-quan;LIANG Jing-ran;GUO Yi;LYU Guang-gui;LI Rui;YI Cheng-la(Department of Pelvis,Yulin Orthopedics Hospital of Chinese and Western Medicine,Yulin 537000,China;Department of Traumatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]玉林市中西医结合骨科医院骨盆科,广西玉林537000 [2]华中科技大学同济医学院附属同济医院创伤外科,武汉430030

出　　处：《骨科》2023年第3期245-249,共5页ORTHOPAEDICS

基　　金：玉林市科学研究与技术开发计划(201934046)。

摘　　要：目的探讨3D打印技术在手术治疗陈旧性骨盆髋臼骨折中的临床意义。方法回顾性分析2019年5月至2022年2月使用3D打印技术辅助治疗的13例陈旧性骨盆髋臼骨折病人的临床资料,其中男9例、女4例。术前应用3D打印技术,按1∶1比例制作病人全骨盆模型,根据模型进行术前决策,模拟骨折复位、截骨、减压,指导术前选择及预弯内固定物。记录手术时间、出血量及术后复位效果。术后复位质量根据Matta评分标准进行评估。末次随访时,采用Merle D’Aubigne和Postel评分、Majeed评分评估疗效。结果13例病人均顺利完成手术,手术时间为(194.38±79.82)min,术中出血量为(534.62±268.46)mL。按Matta标准,骨折复位优3例,良7例,优良率为76.92%。所有病人均获得随访,按照Merle D’Aubigne和Postel评分标准,髋关节功能优1例,良2例,优良率为75%,Majeed评分为(93.00±4.37)分。结论3D打印技术辅助治疗陈旧性骨盆髋臼骨折,有助于了解骨折形态、制定合理的手术方案、提高内固定物植入的精度、减少手术时间及术中出血量。Objective To explore the clinical significance of 3D printing technology in surgical treatment of obsolete pelvic and acetabular fractures.Methods A retrospective analysis was performed on 13 cases of obsolete pelvic and acetabular fractures assisted with 3D printing technology from May 2019 to February 2022.The 3D printing technology was used to make a 1∶1 model of the patient’s total pelvis model before surgery,including 9 males and 4 females.According to the model,the preoperative decision was made,including simulating fracture reduction,osteotomy and decompression,guiding the preoperative selection and pre⁃bending the internal fixators.The operation time,blood loss and postoperative reduction effect were recorded.The quality of postoperative reduction was evaluated according to the Matta scoring criteria.The curative effect was evaluated by leveraging Merle D’Aubigne and Postel score and Majeed score in the last follow⁃up.Results All surgeries of 13 patients were successfully completed.Operation time was(194.38±79.82)min,intraoperative blood loss was(534.62±268.46)mL,and according to the Matta standard,fracture reduction was excellent in 3 cases and good in 7 cases,and the excellent and good rate was 76.92%.All patients were follow⁃up.According to evaluation criterion of Merle D’Aubigne and Postel,the function of hip joint was excellent in 1 case and good in 2 cases,thus the total excellent and good rate was 75%.The Majeed score was(93.00±4.37).Conclusion Assisted treatment of obsolete pelvic acetabular fractures with 3D printing technology is helpful to analyze the morphological characteristics of fracture,formulate a reasonable surgical plan,improve the implantation precision of internal fixation,and reduce the operation time and intraoperative blood loss.

关 键 词：骨盆 髋臼 陈旧性骨折 3D打印 

分 类 号：R687.3[医药卫生—骨科学]