3D打印技术辅助治疗高能量复杂Pilon骨折的临床疗效观察  

Clinical efficacy observation of 3D printing technology assisted treatment for high-energy complex Pilon fractures

作　　者：黄剑云 王本海 刘忠杰 张纪浩 郑明声 张銮弟 郑锦泉 HUANG Jianyun;WANG Benhai;LIU Zhongjie;ZHANG Jihao;ZHENG Mingsheng;ZHANG Luandi;ZHENG Jinquan(Fujian University of Traditional Chinese Medicine Affiliated Third People's HospitalOrthopedics Department 2,Fuzhou 350108,China)

机构地区：[1]福建中医药大学附属第三人民医院骨伤二科,福建福州350108

出　　处：《中华灾害救援医学》2024年第12期1397-1401,共5页Chinese Journal of Disaster Medicine

基　　金：福建省自然科学基金项目(2023J01887);福建中医药大学校管课题(XB2022046)。

摘　　要：目的探讨3D打印技术辅助治疗高能量复杂Pilon骨折的临床疗效。方法选取2018年7月至2023年5月于福建省第三人民医院骨伤科住院治疗的复杂高能量Pilon骨折患者96例。按照治疗方式的不同进行分组,其中48例采用3D打印技术辅助治疗的患者归为研究组,另外48例采用常规方案治疗的患者归为对照组。研究组术前采用3D打印技术打印骨折部位实体模型,利用实体模型模拟手术,复位骨折,预弯钢板,标记钢板位置、置钉方向及长度;对照组参考CT、X线片等影像学资料;两组患者均采用小腿下段前外侧单一切口进入,充分暴露骨折端,对照组参照X线、CT图像将骨块进行尝试复位,复位后选择合适的钢板塑形固定,研究组则依据术前在Pilon骨折3D模型模拟手术中的复位顺序和方法依次复位骨折块,用预先选定的钢板固定。结果对照组术中失血量、手术时间、术中透视次数明显多于研究组,研究组关节面复位更好,不良反应发生率更低,骨折愈合更快,差异均具有统计学意义(P<0.05)。术后1年的AOFAS评分显示研究组高于对照组(P<0.05)。结论复杂高能量Pilon骨折应用3D打印技术辅助治疗,可以显著减少出血量、术中透视次数,减短手术时间,关节面复位好,不良反应发生率低,且术后踝关节功能恢复好,并发症少。Objective To explore the clinical efficacy of 3D printing technology in assisting the treatment of high-energy complex Pilon fractures.Methods 96 patients with complex high-energy Pilon fractures who were hospitalized in the Orthopedics Department of the Third People's Hospital of Fujian Province from July 2018 to May 2023 were selected for treatment.According to different treatment methods,48 patients who received 3D printing technology assisted treatment were classified as the study group,while the other 48 patients who received conventional treatment were classified as the control group.The research group used 3D printing technology to print a solid model of the fracture site before surgery,simulated surgery using the solid model,reduced the fracture,pre bent the steel plate,marked the position of the steel plate,the direction and length of the nail placement;The control group refers to imaging data such as CT and X-ray films;Both groups of patients underwent a single incision on the anterior lateral side of the lower leg to fully expose the fracture site.The control group attempted to reduce the bone block based on X-ray and CT images,and after reduction,selected a suitable steel plate for shaping and fixation.The study group reduced the fracture block according to the preoperative reduction sequence and method in the Pilon fracture 3D model simulation surgery,and fixed it with a pre selected steel plate.The intraoperative blood loss,operation time,and intraoperative fluoroscopy frequency in the control group were significantly higher than those in the study group.Results The study group had better joint surface reduction,lower incidence of adverse reactions,and faster fracture healing,with statistically significant differences(P<0.05).The AOFAS score of the study group was higher than that of the control group patients one year after surgery,and the difference was statistically significant(P<0.05).Conclusion The application of 3D printing technology to assist in the treatment of complex high-energy Pilon fra

关 键 词：3D打印 PILON骨折 骨折固定术 

分 类 号：R274.1[医药卫生—中医骨伤科学]