3D打印技术辅助双钢板个性化手术治疗AO-C型肱骨远端骨折

3D printing assisted double plate individualized surgical treatment of AO type C distal humeral fractures

目的探讨3D打印技术辅助双钢板个性化手术治疗AO-C型肱骨远端骨折的临床疗效。方法回顾性分析自2014-01-2015-12诊治的60例AO-C型肱骨远端骨折,采用3D打印技术辅助双钢板个性化手术治疗30例(观察组),采用常规内固定手术治疗30例(对照组)。比较2组手术时间、术中出血量,以及末次随访时的肘关节功能Mayo评分。结果所有患者均获得随访,随访时间平均12.5(12.0~14.5)个月。观察组手术时间为(98.1±7.7)min,对照组为(143.0±13.0)min;观察组手术时间明显短于对照组,差异有统计学意义(P<0.05)。观察组术中出血量为(140.7±21.3)ml,对照组为(394.3±43.9)ml;观察组术中出血量明显少于对照组,差异有统计意义(P<0.05)。末次随访时根据肘关节功能Mayo评分标准评定疗效:观察组优22例,良6例,可2例,优良率93.3%;对照组优16例,良6例,可6例,差2例,优良率73.3%。观察组肘关节功能Mayo评分优于对照组,差异有统计学意义(P<0.05)。结论采用3D打印技术辅助双钢板内固定治疗AO-C型肱骨远端骨折效果满意,可缩短手术时间,减少术中出血量,有利于患者术后早期功能恢复。

Objective To investigate the clinical effect of 3D printing technology in the individualized surgical treatment of AO type C fractures of distal humerus with double plate fixation. Methods Sixty cases of AO type C distal humeral fractures treated from Jan. 2014 to Dec. 2015 were retrospectively analyzed. 3D printing technology aided double plate individualized surgical treatment was used in 30 cases （observation group） while the conventional internal fixation surgery was performed in 30 cases （control group）. The time of operation, the amount of bleeding during operation, and the Mayo elbow function score were compared between the two groups. Results All 60 patients were followed up for an average of 12.5 （12.0-14.5）months. The operation time of the observation group was （98.1±7.7）min, the control group was （143.0±13.0）min; the operation time of the observation group was shorter than that of the control group, the difference was statistically significant （P 〈0.05）. The intraoperative blood loss in the observation group was （140.7±21.3）ml, and the control group was （394.3±43.9）ml; the bleeding volume in the observation group was significantly less than that in the control group, the difference was statistically significant （P 〈0.05）. At last follow-up, the curative effect was evaluated according to the elbow function Mayo score： the observation group was excellent in 22 cases, good in 6 cases, and fair in 2 cases. The excellent and good rate was 93.3%; the control group was excellent in 16 cases, good in 6 cases, fair in 6 cases, poor in 2 cases, and the excellent and good rate was 73.3%. The Mayo score of elbow function in observation group was better than that in control group, the difference was statistically significant （P 〈0.05）. Conclusion Using 3D printing technique to assist double plate fixation in the treatment of AO type C distal humeral fractures has satisfactory results. It can shorten the operation time, reduce the amount of bleeding during operation, and is beneficial to the early recovery of postoperative function.