3D打印联合骨科手术机器人辅助股骨截骨矫形术1例报告  

3D printing combined with orthopedic robotics‑assisted osteotomy for femurs:A case report

作　　者：董庆元 朱晓彬[1] 杨志强 谢远龙[1] 雷军[1] 蔡林[1] DONG Qingyuan;ZHU Xiaobin;YANG Zhiqiang;XIE Yuanlong;LEI Jun;CAI Lin(Dept.of Spine Surgery and Musculoskeletal Tumor,Zhongnan Hospital of Wuhan University,Wuhan 430071,Hubei,China)

机构地区：[1]武汉大学中南医院脊柱与骨肿瘤科,湖北武汉430071

出　　处：《武汉大学学报(医学版)》2025年第1期99-103,共5页Medical Journal of Wuhan University

基　　金：国家自然科学基金资助项目(编号:82170899)。

摘　　要：目的:报道1例3D打印联合骨科手术机器人辅助截骨矫形术治疗双侧股骨畸形合并膝外翻的病例,以提高对该疾病的治疗水平。方法:选取武汉大学中南医院收治的1例由佝偻病导致双侧股骨畸形合并膝外翻患者,报道其病史、症状、体征、诊治过程和随访结果。结果:本例患者为男性,26岁,因“双下肢畸形12年,双膝疼痛2年”来我院就诊,经双下肢站立全长X线和血生化等检查提示双侧股骨畸形合并膝外翻,佝偻病。根据术前CT设计一种截骨、复位和钢板订位一体化的3D打印导板,联合天玑®骨科手术机器人辅助双侧股骨截骨矫形术治疗,右侧手术2个月后左侧手术,术后给予补液、抗炎、镇痛等对症支持治疗并指导功能锻炼。左侧术后4月、9月和15月随访。术中3次C臂透视;左侧术后4个月随访:X线示截骨断端少许骨痂生长,下肢力线恢复正常,数字评定量表(NRS)评分为0;左侧术后9个月随访:X线示截骨断端模糊,美国特种外科医院膝关节评分(HSS)为100;随访期间未出现相关并发症。结论:3D打印联合骨科手术机器人辅助截骨矫形术治疗双侧股骨畸形合并膝外翻,手术的精确度和准确率高,临床疗效良好,实用性强,具有广阔的应用前景。Objective:To report a case of bilateral femoral deformity with valgus knee treated by using a combination of 3D printing and orthopedic surgical robot-assisted osteotomy orthopedic surgery.Methods:A case of bilateral femoral deformity with genu valgum caused by rickets was implemented in Zhongnan Hospital of Wuhan University.His history,symptoms,signs,diagnosis,treatment,and follow-up results were reported.Results:The case was a 26-year-old male,and came to the hospi-tal for"bilateral lower limb deformity for 12 years,pain in knees for 2 years".The examination,which included a full-length X-ray of the lower limbs in a standing position and blood biochemistry,revealed bilateral femoral deformity with genu valgum and rickets.Based on CT scans,a 3D-printed naviga-tion template was designed to integrate osteotomy,reduction,and plate positioning.Furthermore,a procedure using 3D printing combined with TiRobot-assisted osteotomy was performed for the pa-tient.Two months after the right operation,the left operation was performed.Postoperatively,the patient received symptomatic and supportive treatment,including fluid replacement,anti-inflamma-tion,and analgesia.Additionally,functional exercises were guided.The patient underwent follow-up at the end of 4th,9th,and 15th months post-left operation.C-arm fluoroscopy was performed three times during the operation.At the 4-month follow-up after the left operation,an X-ray revealed that a small callus had formed at the osteotomy's broken end,the force line of the lower limb was normal,and the Numerical Rating Scale(NRS)score was 0.In the 9th month after the left operation,an X-ray showed that the broken end of the osteotomy was blurred and Hospital for Special Surgery knee(HSS)score was 100.There were no related complications during the follow-up.Conclusion:3D printing,when combined with orthopedic surgical robot-assisted osteotomy,enhances orthopedic sur-gery for the treatment of bilateral femoral deformity with external knee varus.This approach offers high accuracy and precis

关 键 词：3D打印 骨科手术机器人 截骨矫形 股骨畸形 膝外翻 

分 类 号：R687[医药卫生—骨科学]