镜像3D打印预螺旋塑形接骨板结合定位导板辅助微创经皮接骨板内固定术治疗成人RobinsonⅡB型锁骨骨折  

Mirror 3D-printed pre-spiral shaped plate combined with positioning guide assisted minimally invasive percutaneous plate osteosynthesis in the treatment of adult RobinsonⅡB clavicle fractures

作　　者：罗俊浩 周明 马运宏 刘军 吴永伟 王建兵 王亚朋 王鹏 康永强 芮永军 LUO Junhao;ZHOU Ming;MA Yunhong;LIU Jun;WU Yongwei;WANG Jianbing;WANG Yapeng;WANG Peng;KANG Yongqiang;RUI Yongjun(Department of Orthopaedic Trauma,Wuxi Ninth People's Hospital,Wuxi 214062,Jiangsu,China)

机构地区：[1]无锡市第九人民医院创伤骨科,江苏无锡214062

出　　处：《中华骨与关节外科杂志》2025年第1期51-56,共6页Chinese Journal of Bone and Joint Surgery

基　　金：无锡市“太湖人才计划”顶尖医学团队课题资助项目(TTPJY202101);无锡市卫生健康委科技成果与适宜技术推广项目(T202324)。

摘　　要：目的:探讨镜像3D打印预螺旋塑形接骨板结合定位导板辅助微创经皮接骨板内固定术(MIPPO)治疗成人RobinsonⅡB型锁骨骨折的临床效果。方法:回顾性选取2018年1月至2020年1月无锡市第九人民医院收治的20例锁骨中段骨折患者作为研究对象。观察患者术后骨折愈合情况、围手术期指标、骨折端复位情况、骨折愈合时间、肩关节功能情况以及术后并发症发生情况。结果:20例患者随访时间为7~21个月,平均(13.7±6.7)个月。所有患者均达到骨性愈合,平均骨折愈合时间为(12.4±3.3)周。20例患者平均切口长度为(6.4±0.9)cm,手术时间为(50.4±11.5)min,术中出血量为(12.0±3.7)mL,术中透视次数为(1.3±0.4)次,术后第3天疼痛视觉模拟评分(VAS)为(3.2±1.3)分,术前及术后即刻骨折短缩程度分别为(10.3±1.9)%、(0.4±0.2)%。术后3个月、6个月和末次随访时,肩关节Constant-Murley评分分别为(92.7±1.0)分、(95.7±1.3)分、(96.6±1.3)分。1例患者术后切口出现脂肪液化,1例患者出现皮神经损伤而导致局部皮肤麻木。结论:镜像3D打印预螺旋塑形接骨板结合定位导板辅助MIPPO治疗成人RobinsonⅡB型锁骨骨折,具有创伤小、恢复快、远期疗效好的优势。远端切口位于锁骨上神经安全区,减小损伤风险,切口小且美观,临床效果满意。Objective:To investigate the clinical effects of mirror 3D-printed pre-spiral shaped plate combined with positioning guide assisted minimally invasive percutaneous plate osteosynthesis(MIPPO)in the treatment of adult RobinsonⅡB clavicle fractures.Methods:A total of 20 patients with midshaft clavicle fractures admitted to Wuxi Ninth People's Hospital from January 2018 to January 2020 were selected as the study subjects.Postoperative fracture healing,perioperative indicators,fracture reduction,fracture healing time,shoulder joint function,and the occurrence of postoperative complications were observed.Results:The mean follow-up time for the 20 patients was(13.7±6.7)months.All patients achieved bone union,with an average fracture healing time of(12.4±3.3)weeks.The mean incision length was(6.4±0.9)cm,the surgical time was(50.4±11.5)min,the intraoperative blood loss was(12.0±3.7)mL,the intraoperative fluoroscopy times were(1.3±0.4),the VAS score on the third postoperative day was(3.2±1.3),the preoperative bilateral clavicle length ratio was(10.3±1.9)%,and the postoperative bilateral clavicle length ratio was(0.4±0.2)%.The Constant-Murley scores of the shoulder joint at 3 months,6 months,and the last follow-up were(92.7±1.0),(95.7±1.3),and(96.6±1.3)points,respectively.One patient experienced fat liquefaction at the incision site after surgery,and another had local skin numbness due to cutaneous nerve injury.Conclusions:Mirror 3D-printed pre-spiral shaped plate combined with MIPPO in the treatment of adult RobinsonⅡB clavicle fractures has the advantages of minimal trauma,rapid recovery,and good long-term outcomes.The distal incision is located in the supraclavicular nerve safety zone,reducing the risk of injury,with small and aesthetic incisions,and satisfactory clinical outcomes.

关 键 词：镜像 3D打印 预螺旋塑形接骨板 定位导板 微创经皮接骨板内固定术 

分 类 号：R687.3[医药卫生—骨科学]