计算机辅助设计和快速成型技术行复杂髋臼骨折的治疗效果观察

Efficacy of Computer-aided Design and Rapid Prototyping in Treatment of Complicated Acetabular Fractures

目的：比较利用计算机辅助设计（Computer-aided Design,CAD）和快速成型技术（Rapid Prototyping,RP）与传统手术行切开复位内固定治疗复杂髋臼骨折的临床和放射学疗效。方法：2008年6月至2014年1月收治的45例复杂髋臼骨折患者,自2011年6月开始利用计算机辅助设计及快速成型技术治疗。其中CAD/RP组23例,传统手术组22例,术后采用改良Matta髋臼骨折复位标准评定骨折复位质量,末次随访时采用改良Postel-Merle dAubigné功能评分标准评定髋关节功能,并记录随访过程中出现的并发症。结果：45例患者均获得随访,随访时间为10~38个月,平均20.71个月。根据改良Matta髋臼骨折复位标准,CAD/RP组中解剖复位14例,良好复位8例,不满意复位1例;传统手术组解剖复位10例,良好复位6例,不满意复位6例。末次随访改良Postel-Merle dAubigné髋关节功能评分：CAD/RP组中优15例,良6例,可1例,差1例;传统手术组优8例,良8例,可4例,差2例。结论：与传统手术相比,利用CAD和RP进行切开复位内固定治疗复杂髋臼骨折,具有手术创伤小,出血量少,固定可靠,手术并发症少,安全性高,疗效可靠等优点。

Objective：To compare the clinical and radiological efficacy of computer-aided design（CAD）and rapid prototy ping（RP） with traditional open reduction and internal fixation in treating complicated acetabular fractures. Methods： From June 2008 to January 2014,45 patients with complicated aeetabular fractures were treated in our department, 22 cases in CAD / RP group and 23 cases in traditional operation group. Modified Matta acetabular fractures reduclion slandard was used to assess the reduction quality. The modified Postel-Merle d＇Aubigne functional assessment criteria was used to assess hip function, and complications were recorded during follow-up. Results： All 45 patients were followed up for l0b 38 months,averaged 20.71 months. According to the modified Matta evaluation system, 14 cases had anatomic reduction, 8 cases satisfactory reduction,and 1 case dissatisfactory reduction in the CAD/RP group,while 10 cases had anatomic reduction,6 cases satisfactory reduction,and 6 case dissatisfactory reduction in the traditional surgical group. According to the Modified Postel-Merle d＇Aubigne evaluation system at the last follow-up, 15 excellent, 6 good, 1 fair and one poor in the CAD/RP group and 8 excellent,8 good,4 fair and 2 poor in the traditional surgical group. Conclusion：Compared with traditional operation,CAD and RP treating complicated acetabular fractures were safe and effective with less trauma, less bleeding, reliable fixation and few complications.