3D打印导板辅助铰链外固定支架固定在肘部损伤三联征中的应用  

Hinged external fixator placement assisted by a 3D printed guide plate for elbow terror triad

作　　者：陈佳鑫 马星星 张文东 Chen Jiaxin;Ma Xingxing;Zhang Wendong(Department of Orthopedics,Northern Jiangsu People's Hospital Affiliated to Yangzhou University,Yangzhou 225000,China;Department of Geriatrics,Northern Jiangsu People's Hospital Affiliated to Yangzhou University,Yangzhou 225000,China)

机构地区：[1]扬州大学附属苏北人民医院骨科,扬州225000 [2]扬州大学附属苏北人民医院老年科,扬州225000

出　　处：《中华创伤骨科杂志》2025年第1期76-83,共8页Chinese Journal of Orthopaedic Trauma

摘　　要：目的探讨3D打印导板辅助铰链外固定支架固定在肘部损伤三联征中的应用效果。方法回顾性分析2021年7月至2023年7月于扬州大学附属苏北人民医院骨科术中使用3D打印导板辅助铰链外固定支架固定治疗10例肘部损伤三联征的患者资料。男6例,女4例;年龄(48.2±19.7)岁。记录并比较术前与末次随访时患者肘关节活动度和疼痛视觉模拟评分(VAS)。记录末次随访时Mayo肘关节功能评分(MEPS)和并发症发生情况。结果10例患者术中使用3D打印导板均一次性成功定位肘关节旋转中心轴,术中透视和术后CT计算机模拟验证铰链外固定支架与肘关节旋转中心一致。所有患者术后获12.0(5.5,13.5)个月随访。末次随访时10例患者屈伸、旋转活动度分别为126.2°±6.1°、153.2°±5.9°,均较术前(23.3°±6.7°、121.2°±5.7°)显著提高,差异均有统计学意义(P<0.05)。末次随访时疼痛VAS评分为1(0,1)分,较术前的3(2,3)分显著降低,差异有统计学意义(P<0.05)。末次随访时MEPS评分为(88.0±6.8)分,其中优6例,良4例。无一例患者出现针道感染、固定针松动或断裂、桡神经损伤等并发症,2例患者出现异位骨化,1例患者因尺神经症状进行了二次手术神经松解。结论肘部损伤三联征手术治疗中应用3D打印导板辅助铰链外固定支架固定,可以快速、精确定位肘关节旋转中心轴,获得较为满意的功能预后。ObjectiveTo investigate the efficacy of a 3D printed guide plate in the placement of a hinged external fixator for treatment of elbow terror triad.MethodsA retrospective study was conducted to analyze the data of 10 patients with elbow terror triad who had been treated at Department of Orthopedics,Northern Jiangsu People's Hospital Affiliated to Yangzhou University from July 2021 to July 2023 by the hinged external fixator placement assisted by a 3D printed guide plate.There were 6 males and 4 females,aged(48.2±19.7)years.The range of elbow motion and visual analogue scale(VAS)pain score in the patients were recorded and compared between preoperation and the last follow-up.Mayo elbow performance score(MEPS)and complications were also recorded at the last follow-up.ResultsThe central axis of the elbow rotation was successfully located at one time under the assistance of the 3D printed guide plate in the 10 patients.Intraoperative fluoroscopy and postoperative CT computer simulation verified that the rotation center of the hinged external fixator was consistent with that of the elbow joint.All patients were followed up for 12.0(5.5,13.5)months.The elbow flexion and extension at the last follow-up in the 10 patients were 126.2°±6.1°and 153.2°±5.9°,respectively,significantly better than those before operation(23.3°±6.7°and 121.2°±5.7°)(P<0.05).Their VAS pain score was 1(0,1)point at the last follow-up,significantly lower than that before operation[3(2,3)points](P<0.05).Their MEPS score at the last follow-up was(88.0±6.8)points,giving 6 excellent and 4 good cases.No patient experienced such complications as pin tract infection,loosening or breakage of fixation needles,or radial nerve injury.Ectopic ossification occurred in 2 patients,and 1 patient underwent a secondary nerve release due to ulnar nerve symptoms.ConclusionIn the surgical treatment of elbow terror triad,application of a 3D printed guide plate to assist the placement of an external fixator can quickly and accurately locate the central axis o

关 键 词：肘关节 脱位 外固定器 关节不稳定性 3D成像 

分 类 号：R687.3[医药卫生—骨科学]