3D打印技术在复杂胫骨平台骨折中的应用

Application of 3D printing in complex tibial plateau fractures

目的探讨3D打印技术在复杂胫骨平台骨折中的应用效果。方法以我院2013年1月-2015年1月收治的18例复杂胫骨平台骨折患者为研究对象,术前均通过3D打印技术辅助设计内固定方案,并按照术前设计方案手术,为观察组。选择同期采取常规术前检查及手术治疗的22例患者为对照组,术后随访3-6个月,比较两组手术相关指标、骨性愈合时间及手术前后HSS膝关节评分。结果观察组手术时间、术中出血量、骨性愈合时间及术后6个月HSS评分分别为（90.5±10.3）分钟、（532.6±254.3）m L、（3.2±0.5）个月、（86.7±10.4）分,较对照组的（153.4±30.8）分钟、（768.5±310.7）m L、（4.1±0.7）个月、（78.6±6.7）分差异有统计学意义（P〈0.01）。末次随访观察组膝关节功能恢复优良率94.4%,高于对照组的81.8%,但无显著差异（P〉0.05）。结论 3D打印技术下模拟手术能明显缩短复杂胫骨平台骨折患者实际手术时间及骨性愈合时间,有效提高手术效率,促进膝关节功能良好恢复,值得深入研究。

Objective To explore the application effect of 3D printing in complex tibial plateau fractures. Methods 18 cases of patients with complex tibial plateau fractures admitted into the hospital from Jan2013 to Jan 2015 were selected as the research object. The plans for internal fixation were designed with the help of 3D printing before operation. And the operation was completed according to the scheme designed before operation, as the observation group. Another 22 patients receiving routine preoperative examination and surgical treatment during the same period were taken as the control group.With 3 to 6 months of postoperative follow-up, indicators related to operation, bony healing time and postoperative HSS knee score were compared between the two groups. Results In the observation group, operative time, amount of intranperative blood loss, bone healing time and HSS score 6 months after operation respectively were（90.5±10.3）min,（532.6±254.3）m L,（3.2±0.5）months and（86.7±10.4）points. Compared with（153.4±30.8）min,（768.5±310.7）m L,（4.1±0.7） months and（78.6±6.7） in the control group, the differences were statistically significant（P〈0.01）.The excellent and good rate of the recovery of knee joint function was 94.4% which was higher than 81.8% of the control group at the end of the follow-up, but there was no significant difference（P〉0.05）. Conclusion Simulated operation under 3D printing can significantly shorten the actual operation time for complex tibial plateau fractures and bone healing time, effectively improve the operation efficiency and promote the recovery of knee joint function.