3D打印技术在腓骨头上入路治疗复杂胫骨平台后外侧骨折中的临床应用  

Clinical application of 3D printing technology in the treatment of complex posterolateral tibial plateau fractures using the suprafibular approach

作　　者：刘波[1] 曹光华[1] 张文玺[1] 杨栋[1] 姜辉[1] 乔之军 LIU Bo;CAO Guanghua;ZHANG Wenxi;YANG Dong;JIANG Hui;QIAO Zhijun(Department of Orthopedics,Liyang People′s Hospital in Jiangsu Province,Liyang,Jiangsu,213300)

机构地区：[1]江苏省溧阳市人民医院骨科,江苏溧阳213300

出　　处：《实用临床医药杂志》2024年第5期17-20,58,共5页Journal of Clinical Medicine in Practice

基　　金：江苏省常州市卫生计生委重大科技项目(ZD201927)。

摘　　要：目的探讨3D打印技术在腓骨头上入路治疗复杂胫骨平台后外侧骨折中的临床应用价值。方法回顾性分析67例接受腓骨头上入路治疗的复杂胫骨平台后外侧骨折患者的临床资料,根据术前是否采用3D打印模拟手术将患者分为3D打印组35例和常规组32例。比较2组患者的手术时间、术中出血量、术中透视次数,观察术后切口感染、腘血管损伤、腓总神经损伤等并发症发生情况。随访骨折愈合时间,术后6个月评估Rasmussen评分,末次随访时评估美国特种外科医院(HSS)膝关节功能评分。结果67例患者随访时间为14~22个月;2组各有1例患者发生术后切口感染,均未发生腘血管损伤、腓总神经损伤、下肢深静脉血栓等并发症;3D打印组患者手术时间、术中出血量、术中透视次数均短于或少于常规组,差异有统计学意义(P<0.05);2组患者骨折愈合时间、术后6个月Rasmussen评分、末次随访时HSS评分比较,差异无统计学意义(P>0.05)。结论3D打印技术应用于复杂胫骨平台后外侧骨折患者的腓骨头上入路治疗中,可以优化手术方案,缩短手术时间,减少术中出血量和透视次数。Objective To investigate the clinical application value of 3D printing technology in the treatment of complex posterior lateral tibial plateau fractures using the suprafibular approach.Methods A retrospective analysis was conducted on the clinical data of 67 patients with complex posterior lateral tibial plateau fractures treated with the suprafibular approach.Patients were divided into 3D printing group(35 cases)and conventional group(32 cases)based on whether 3D printing simulation surgery was used preoperatively.The operation time,intraoperative blood loss,and intraoperative fluoroscopy frequency were compared between the two groups.Postoperative complications such as incision infection,popliteal vessel injury,and common peroneal nerve injury were observed.Fracture healing time was recorded during follow-up,and Rasmussen scores were evaluated at 6 months postoperatively.The Hospital for Special Surgery(HSS)knee function score was assessed during the final follow-up.Results The follow-up duration for 67 patients was 14 to 22 months.One patient in each group developed postoperative incision infection,and no complications such as popliteal vessel injury,common peroneal nerve injury,or deep venous thrombosis of the lower extremity occurred.The operation time,intraoperative blood loss,and intraoperative fluoroscopy frequency were significantly lower in the 3D printing group than in the conventional group(P<0.05).There were no significant differences in fracture healing time,Rasmussen scores at 6 months postoperatively,and HSS scores during the final follow-up between the two groups(P>0.05).Conclusion The application of 3D printing technology in the treatment of complex posterior lateral tibial plateau fractures using the suprafibular approach can optimize surgical plans,shorten operation time,and reduce intraoperative blood loss and fluoroscopy frequency.

关 键 词：3D打印 骨折 胫骨平台 腓骨头上入路 内固定 

分 类 号：R683.42[医药卫生—骨科学] R687.3[医药卫生—外科学] R319[医药卫生—临床医学]