3D打印技术结合锁定接骨板固定在股骨畸形患者股骨干骨折中的应用  

Application of 3D printing technology combined with locking plate fixation in femoral shaft fracture of patients with femoral deformity

作　　者：苏雨 马腾[2] 王谦[2] 李明[2] 许毅博 路遥[2] 杜兵 姬帅 李东晨 崔玉 杨彦玲[1] 任程[2] 张堃[2] 李忠[2] Su Yu;Ma Teng;Wang Qian;Li Ming;Xu Yibo;Lu Yao;Du Bing;Ji Shuai;Li Dongchen;Cui Yu;Yang Yanling;Ren Cheng;Zhang Kun;Li Zhong(Medical College of Yan'an University,Yan'an 716000,China;Department of Traumatic Orthopedics,Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]延安大学医学院,延安716000 [2]西安交通大学附属红会医院创伤骨科,西安710054

出　　处：《国际外科学杂志》2023年第11期731-737,F0004,共8页International Journal of Surgery

基　　金：陕西省自然科学基金(S2022-JC-YB-1539, 2022JQ-299, S2022-JC-QN-1502)。

摘　　要：目的分析3D打印技术结合锁定接骨板固定对股骨畸形患者股骨干骨折的临床疗效。方法采用回顾性队列研究的方法, 分析2014年6月—2020年12月西安交通大学附属红会医院收治的33例接受锁定接骨板固定治疗的存在股骨畸形的股骨干骨折患者的临床资料, 根据术前是否进行3D打印分为3D打印组(n=18)和对照组(n=15)。3D打印组患者中, 男性11例, 女性7例;年龄为(46.78±13.76)岁;对照组患者中, 男性9例, 女性6例;年龄为(48.20±14.27)岁。记录两组患者的手术时间、术中出血量、骨折愈合时间、并发症发生情况。对患者术前和术后6、12、24、48、72 h疼痛视觉模拟评分(VAS)进行评估。依据髋关节Harris评分、美国特种外科医院膝关节功能评分(HSS)、中文版健康状况调查简表(SF-36)对患者伤前及术后12个月髋关节、膝关节功能及生存质量进行评价。计量资料以均数±标准差(±s)表示, 组间比较采用t检验;计数资料组间比较采用χ^(2)检验或Fisher确切概率法。结果 3D打印组患者手术时间、术中出血量、并发症发生率分别为(91.50±9.07) min、(191.11±16.01) mL、0(0/18), 对照组分别为(118.07±14.19) min、(270.27±17.59) mL、26.7%(4/15), 两组相比差异均具有统计学意义(P<0.05)。3D打印组术后6、12、24、48、72 h疼痛VAS均显著优于对照组(P<0.05)。在骨折愈合时间和术前疼痛VAS评分方面, 两组相比差异无统计学意义(P>0.05)。两组患者在伤前、术后12个月髋关节功能、膝关节功能及生存质量评分方面差异均无统计学意义(P>0.05)。结论在采用锁定接骨板固定治疗的股骨畸形患者股骨干骨折术中, 应用3D打印技术可以进行术前设计和钢板预塑形, 能够缩短手术时间, 减少术中出血量, 降低疼痛VAS评分及并发症发生率, 提高手术满意度, 为治疗股骨畸形患者的股骨干骨折提供新的选择。Objective To analyze the therapeutic effect of 3D printing technology combined with locking plate fixation on femoral shaf fracture in patients with femoral deformity.Methods The clinical data of 33 patients with femoral shaft fracture with femoral deformity who met the inclusion criteria and underwent locking plate fixation in the Xi'an Honghui Hospital Affiliated to Xi'an Jiaotong University from June 2014 to December 2020 were retrospectively analyzed.The patients were divided into 3D printing group(n=18)and control group(n=15)according to whether 3D printing was performed before operation.The 3D printing group including 11 males and 7 females with an age of(46.78±13.76)years.The control group including 9 males and 6 females with an age of(48.20±14.27)years.The operation time,intraoperative blood loss,fracture healing time and complications of the two groups were recorded.Visual analogue scale(VAS)scores of pain were evaluated before and 6,12,24,48 and 72 h after operation.According to the Harris hip score,the Hospital for Special Surgery(HSS)knee score and The MOS 36-item short-from Health Survey(SF-36),the hip and knee function and quality of life of the patients before and 12 months after injury were evaluated.The measurement data were represented as mean±standard deviation(x±s),and the comparison between groups was conducted using the t-test;the comparison of count data between groups was conducted by Chi-square test or Fisher exact probability.ResulstsThe operation time,intraoperative blood loss,and incidence of complications in the 3D printing group were(91.50±9.07)min,(191.11±16.01)mL,and0(0/18),respectively,and those in the control group were(118.07±14.19)min,(270.27±17.59)mL,and 26.7%(4/15),the differences between the two groups were statistically significant(P<0.05).The pain VAS scores of the 3D printing group were significantly better than those of the control group at 6,12,24,48,and 72 h after operation(P<0.05).There were no differences in fracture healing time and preoperative pain VAS bet

关 键 词：股骨骨折 骨折固定术 畸形 3D打印 锁定接骨板 

分 类 号：R687.3[医药卫生—骨科学]