3D打印导向器在镜下前交叉韧带胫骨撕脱骨折固定术中的应用效果  

Application of 3D printing guide in microscopic anterior cruciate ligament tibial avulsion fracture fixation

作　　者：赵程锦[1] 冯阳阳[1] 李楠楠 ZHAO Chengjin;FENG Yangyang;LI Nannan(Department of Trauma Orthopedics,Yanan University Affiliated Hospital,Yan’an 716000,China)

机构地区：[1]延安大学附属医院创伤骨科,陕西延安716000

出　　处：《机器人外科学杂志(中英文)》2025年第3期368-372,共5页Chinese Journal of Robotic Surgery

基　　金：国家自然科学基金(82160431)。

摘　　要：目的:分析3D打印导向器在镜下前交叉韧带(ACL)胫骨撕脱骨折固定术中的临床应用及疗效。方法:选取延安大学附属医院创伤骨科于2020年10月—2024年10月收治的ACL胫骨撕脱骨折患者100例,随机分为常规组(行常规镜下ACL胫骨撕脱骨折固定术,n=50)和3D组(行3D打印导向器辅助镜下ACL胫骨撕脱骨折固定术,n=50)。比较两组患者的围手术期指标、膝关节功能、生活质量、屈曲挛缩发生率及并发症发生率。结果:3D组患者术中出血量、术后引流量、手术时间、骨折愈合时间、开始膝关节功能锻炼时间、住院时间均少于常规组(P<0.05)。治疗前两组患者国际膝关节文献委员会评分、Tegner膝关节运动评分、Lysholm膝关节评分比较,差异无统计学意义(P>0.05),治疗后两组患者各项评分均升高,且3D组高于常规组(P<0.05)。治疗前两组患者健康调查简表各维度评分比较,差异无统计学意义(P>0.05),治疗后两组患者各维度评分均升高且3D组高于常规组(P<0.05)。3D组患者5°屈曲挛缩发生率、屈曲挛缩总发生率以及并发症发生率均低于常规组(P<0.05)。结论:3D打印导向器在镜下ACL胫骨撕脱骨折固定术中临床应用效果显著,可有效促进患者术后康复及膝关节功能恢复,提高生活质量,减少屈曲挛缩发生及并发症发生,临床推广优势大。Objective:To analyze the clinical application and efficacy of 3D printing guide in microscopic anterior cruciate ligament(ACL)tibial avulsion fracture fixation.Methods:100 patients with ACL tibial avulsion fractures in the Department of Trauma Orthopedics of the Yanan University Affiliated Hospital from October 2020 to October 2024 were selected and randomly divided into the conventional group(conventional microscopic ACL tibial avulsion fracture fixation,n=50)and the 3D group(3D printing guide-assisted microscopic ACL tibial avulsion fracture fixation,n=50).The perioperative indicators,knee function,quality of life,incidence of flexion contracture,and complication rate were compared between the two groups.Results:Patients in the 3D group experienced less intraoperative bleeding,postoperative drainage,operative time,fracture healing time,time to start knee function exercises,and length of hospital stay than those in the conventional group(P<0.05).The International Knee Documentation Committee score,Tegner knee motion score,Lysholm knee score,and Health Survey Short Form Score showed no statistically significant difference between the two groups before treatment(P>0.05).While all scores in both groups increased after treatment,and the 3D group outperformed the conventional group(P<0.05).In the 3D group,there was a decreased incidence of 5°flexion contracture,total flexion contracture,and complications compared to the conventional group(P<0.05).Conclusion:The clinical efficacy of 3D printing guides in microscopic ACL tibial avulsion fracture fixation is remarkable,it can effectively promote postoperative knee joint function recovery,improve the quality of life,reduce the incidence of flexion contracture and complications,which is worthy of clinical promotion.

关 键 词：前交叉韧带 胫骨撕脱骨折 3D打印导向器 膝关节功能 

分 类 号：R687.4[医药卫生—骨科学]