3D打印辅助双侧钢板内固定在复杂性胫骨平台骨折中的疗效观察  

Observation of the efficacy of 3D printing assisted with internal fixation of both plates in the treatment of complex fractures of the plateau of the shin

作　　者：倪博文[1] 于泓[1] 于洋[1] 曲鹏玮 许嵩 NI Bowen;YU Hong;YU Yang;QU Pengwei;XU Song(Department of Trauma and Orthopedics,Weihai Municipal Hospital,Weihai 264200,Shandong,China)

机构地区：[1]威海市立医院创伤骨科,山东威海264200

出　　处：《西部医学》2024年第12期1819-1822,1828,共5页Medical Journal of West China

基　　金：山东省中医药科技发展计划项目(2020-330)。

摘　　要：目的分析3D打印辅助双侧钢板内固定对复杂性胫骨平台骨折患者治疗的效果。方法回顾性分析我院2019年9月—2022年9月收治的105例复杂胫骨平台骨折患者病例资料,根据不同治疗方法将其分为对照组(47例)和辅助组(58例)。对照组给予传统钢板内固定术治疗,辅助组在双侧钢板内固定术治疗前给予3D打印。随访术后平均随访12~48个月,对比两组患者临床治疗效果、治疗前后膝关节Lysholm评分、Rasmussen骨折复位满意度评分、膝关节活动度(ROM)并记录其不良反应。结果辅助组临床治疗总有效率高于对照组(P<0.05)。治疗后,辅助组手术时间、术中出血量、骨折痊愈时间均低于对照组(P<0.05);两组膝关节Lysholm评分比较差异无统计学意义(P>0.05)。治疗后3个月、6个月两组Rasmussen评分均升高(P<0.05),且辅助组评分均高于对照组(P<0.05)。治疗3个月、末次随访时,两组关节活动度均升高(P<0.05),且辅助组均高于对照组(P<0.05)。结论对复杂胫骨平台骨折患者给予3D打印辅助治疗,有助于骨折术后膝关节恢复,获得较高的骨折复位满意度,可作为目前治疗复杂胫骨平台骨折的理想方式。Objective To analyze the effect of 3D printing assisted by double plate in the treatment of patients with complex tibial plateau fractures.Methods The clinical data of 105 patients with complex tibial plateau fracture admitted to our hospital from September 2019 to September 2022 were retrospectively analyzed,and they were divided into control group(47 cases)and auxiliary group(58 cases)according to different treatment methods.The control group was treated with traditional plate internal fixation,and the auxiliary group was given 3D printing before bilateral plate internal fixation.The average follow-up period was 20.15 months(12-48 months).The clinical efficacy,Lysholm score,Rasmussen satisfaction score for fracture reduction and knee range of motion(ROM)were observed and compared between the two groups before and after treatment,and adverse reactions were recorded.Results The total effective rate of the adjuvant group was higher than that of the control group(96.55%vs 82.98%,P<0.05).After treatment,the recovery time of each item in the auxiliary group was lower than that in the control group[(67.23±8.10)min vs(103.24±12.14)min,(12.19±1.54)min vs(15.66±2.35)min,(151.29±17.48)mL vs(250.37±27.16)mL](P<0.05);there was no difference in Lysholm score of knee joint between the two groups(P>0.05).The Rasmussen scores of the two groups were increased 3 and 6 months after treatment(P<0.05),and the scores of the auxiliary group were higher than those of the control group(21.25±3.23)vs(18.49±2.71),(27.66±3.53)vs(23.24±3.15))(P<0.05).After 3 months of treatment and at the last follow-up,the range of motion of joints in both groups increased(P<0.05),and the auxiliary group was higher than the control group[(94.35±10.66)°vs(89.35±10.01)°,(118.21±18.54)°vs(111.08±12.36)°](P<0.05).Conclusion 3D printing assisted treatment for patients with complex fractures of the plateau of the shin helps to recover the knee joint after fracture surgery and achieve higher satisfaction with fracture reduction.It could be used

关 键 词：双侧钢板内固定 3D打印 复杂胫骨平台骨折 疗效 膝关节功能 骨折复位满意度 

分 类 号：R683[医药卫生—骨科学]