3D打印体外建模辅助微创治疗复杂骨盆骨折

3D printing in vitro modeling for minimally invasive treatment of complex pelvic fractures

目的探讨3D打印体外建模辅助微创治疗复杂骨盆骨折的临床疗效。方法选择2016年4月至2017年6月采用3D打印体外建模辅助治疗的18例复杂骨盆骨折病例,记录手术时间及术中出血量,术后通过X射线片、CT及Matta评分标准评估骨折复位情况,通过Majeed功能评分评估功能恢复情况。结果手术时间80～160 min,平均(120±23.1) min;术中出血量75～160 m L,平均(113.6±29.1) m L;切口长度7～14 cm,平均(9.3±1.8) cm。18例患者均获随访12～24个月,平均15.8个月。根据Matta评分标准,骨折复位:优12例,良4例,可2例,优良率88.9%。术后6个月使用Majeed评分标准评定功能恢复情况,结果显示:优13例,良4例,可1例,优良率94.4%。所有患者随访期间无内固定松动、断裂等并发症发生。结论采用3D打印体外建模辅助治疗复杂骨盆骨折可使手术操作更加精准及微创,减少并发症的发生,有利于患者术后康复。

Objective To explore the clinical effect of 3D printing in vitro modeling for minimally invasive treatment of complex pelvic fractures.Methods From April 2016 to June 2017,18 cases of complex pelvic fractures were treated by 3D printing in vitro modeling were selected.The operation time and intraoperative bleeding volume were recorded.Fracture reduction was evaluated by X-ray,CT and Matta scores,and functional recovery was assessed by Majeed score.Results All 18 patients were followed up for 12 to 24 months,with an average of 15.8 months.The operation time of 18 patients was 80~160 minutes,with an average of(120±23.1)minutes;the amount of bleeding was 75~160 mL,with an average of(113.6±29.1)mL;the length of incision was 7~14 cm,with an average of(9.3±1.8)cm.According to the Matta score,the fracture reduction was excellent in 12 cases,good in 4 cases,fair in 2 cases,the excellent and good rate was 88.9%.Majeed score was used to evaluate functional recovery 6 months after operation,the results showed that 13 cases were excellent,4 cases were good and 1 case was fair,the excellent and good rate was 94.4%.No complications such as internal fixation loosening or breakage occurred during the follow-up period.Conclusion For complex pelvic fractures,3D printing in vitro modeling assisted minimally invasive surgery can make the operation more precision with less trauma,reduce the incidence of complications,and speed up the recovery of patients.