基于3D打印技术的复杂胫骨平台骨折内固定手术数字化设计

Internal fixation surgery planning for complex tibial plateau fracture based on digital design and 3D printing

目的探讨3D打印技术结合数字化技术在复杂胫骨平台内固定植入方案设计中的应用价值。方法收集临床复杂胫骨平台骨折病例以及常用胫骨平台钢板的CT数据,在Mimics中进行骨折三维重建、虚拟复位以及建立钢板三维模型库,然后进行内固定方案的数字化设计。3D打印出骨折复位模型以及钢板模型,在3D模型上按照数字化设计内固定方案进行模拟手术。比较数字化虚拟手术与3D模型模拟手术的内固定植入效果。结果 3D模型模拟手术的手术效果与内固定数字化设计方案的手术效果一致,二者螺钉长度无明显差异(t=-1.594;v=12;P=0.137)。结论 3D打印技术结合数字化设计能有效的提高复杂胫骨平台骨折内固定植入效果。

Objective To investigate the application of 3D printing and digital technology in preoperative assessment and planning of internal fixation surgery for complex tibial plateau fracture. Methods Complex tibial plateau fractures and commonly used plates for tibial plateau were imaged using computed tomography（CT） to reconstruct the 3D fracture and plate models. The 3D models were used to perform virtual reduction and preoperative planning of internal fixation surgery with the most appropriate plates assisted by the 3D library of plates. According to the optimal plan, the 3D physical models of tibial plateau fractures and plates were 3D printed to simulate internal fixation operation. The effects of internal fixation were compared between the virtual surgery and the simulated surgery based on the 3D models. Results The effects of internal fixation in the simulated surgery based on the 3D models were consistent with those of the virtual surgery. No significant difference was found in the screw length between the two surgeries. Conclusion The combination of 3D printing and digital design can improve the effects of internal fixation for complex tibial plateau fractures.