3D打印辅助PMMA骨水泥髓内支撑在肱骨近端骨质疏松性骨折治疗中的应用  

Application of 3D printing-assisted PMMA bone cement intramedullary support in the treatment of osteoporotic fractures of the proximal humerus

作　　者：尹伟 于洋 宋永财 黄军刚 周娟 杨立峰 YIN Wei;YU Yang;SONG Yongcai;HUANG Jungang;ZHOU Juan;YANG Lifeng(Department of Traumatic Orthopaedics,General Healthcare Hanzhong 3201 Hospital,Hanzhong 723000,China)

机构地区：[1]通用医疗汉中三二〇一医院创伤骨科,陕西汉中723000

出　　处：《机器人外科学杂志(中英文)》2025年第3期373-378,共6页Chinese Journal of Robotic Surgery

基　　金：陕西省重点研发计划项目(2019-SF-168)。

摘　　要：目的:分析3D打印辅助聚甲基丙烯酸甲酯(PMMA)骨水泥髓内支撑在NeerⅡ、Ⅲ、Ⅳ型肱骨近端骨质疏松性骨折治疗中的应用。方法:回顾性分析2021年10月—2023年11月在通用医疗汉中三二〇一医院接受3D打印辅助PMMA骨水泥髓内支撑治疗的90例老年肱骨近端骨质疏松性骨折患者的临床资料,根据Neer分型将所有患者分为NeerⅡ型骨折组(n=28)、NeerⅢ型骨折组(n=37)和NeerⅣ型骨折组(n=25),并观察患者的康复情况。结果:三组患者术前患侧颈干角显著小于健侧颈干角(P<0.05),而术后6个月患侧颈干角与健侧颈干角比较,差异无统计学意义(P>0.05)。三组患者术中与术后6个月的肱骨头高度差值均<5 mm。三组患者术后不同时点的VAS评分和Constant-Murley评分均低于术前,差异有统计学意义(P<0.05);各组内不同时点评分两两比较,差异有统计学意义(P<0.05)。与术前相比,三组患者术后6个月的生活质量各维度评分明显升高,差异有统计学意义(P<0.05)。结论:对老年NeerⅡ、Ⅲ、Ⅳ型肱骨骨质疏松性骨折患者行3D打印辅助PMMA骨水泥髓内支撑治疗能有效促进患者术后恢复,效果良好。Objective:Analyze the application of 3D printing-assisted polymethylmethacrylate(PMMA)bone cemented intramedullary support in the treatment of NeerⅡ,Ⅲ,andⅣosteoporotic fracture of the proximal humerus.Methods:90 elderly patients with osteoporotic fractures of the proximal humerus who were treated with 3D printing-assisted PMMA bone cemented intramedullary support in General Healthcare Hanzhong 3201 Hospital from October 2021 to November 2023 were retrospectively selected and divided into the NeerⅡfracture group(n=28),the NeerⅢfracture group(n=37)and the NeerⅣfracture group(n=25)according to the Neer classification,and the rehabilitation conditions of patients was observed.Results:The preoperative humeral neck-shaft angle of the affected side was all significantly smaller than that of the healthy side in the three groups(P<0.05),whereas the difference was not statistically significant at 6 months after surgery(P>0.05).The differences in humeral head height between intraoperative and postoperative 6-month measurements were all<5 mm in the three groups.VAS scores and Constant-Murley scores at different postoperative timepoints were all significantly lower than those befor surgery in the three groups(P<0.05),and the scores at different timepoints in pairwise comparisons showed significant differences(P<0.05).The scores on quality of life in all dimensions were significantly increased in the three groups at 6 months postoperatively compared with those before surgery(P<0.05).Conclusion:Application of 3D printing-assisted PMMA bone cement intramedullary support in treating elderly Neer typeⅡ,Ⅲ,andⅣosteoporotic fractures of the humerus can effectively promote the postoperative recovery and has a good application effect.

关 键 词：3D打印技术 聚甲丙烯酸甲酯 肱骨骨折 骨质疏松 

分 类 号：R683.4[医药卫生—骨科学]