3D打印骨折模型在肱骨远端C型骨折中的应用

Application of 3D printing fracture model in the treatment of distal humerus C-type fracture

目的比较应用3D打印骨折模型手术与传统手术治疗肱骨远端C型骨折的疗效分析。方法回顾性分析承德医学院附属医院2013年1月—2017年1月收治的59例肱骨远端C型骨折治疗患者。其中27例患者自愿采用3D打印技术,打印出实体模型,并在3D模型上进行模拟手术,术中按照术前计划手术。32例进行常规X射线,CT三维重建扫描,常规传统手术治疗。记录两组手术时间、术中透视次数及术中出血量,并根据Mayo评分评价肘关节术后3个月功能恢复情况,术后6个月肘关节活动度、骨折愈合时间及手术并发症发生率。结果 3D打印组手术后3个月Mayo肘关节评分、术后6个月肘关节活动度优于传统手术组(P<0.05),3D打印组手术时间、术中透视次数及术中出血量等低于传统手术组(P<0.05);两组骨折愈合时间及并发症发生率比较,差异无统计学意义(P>0.05)。结论肱骨远端C型疾病治疗应用3D打印骨折模型辅助手术治疗,可取得更好的临床效果。

Objective To compare the effects of operation with 3D printing fracture model and traditional operation on the treatment of distal humerus c-type fracture.Methods The retrospective analysis of 59 patients with distal humerus c-type fractures in our hospital from January 2013 to January 2017 was used.Among them,27 patients volunteered to use 3D printing technology,print out the physical model and perform simulated operation on the 3D model.The operation was planned according to the preoperative plan(3D printing group,n=27).The other 32 patients underwent conventional X-ray,CT three-dimensional reconstruction and conventional surgery(traditional surgery group,n=32).The two groups were compared in terms of the operation time,frequency of intraoperative fluoroscopy,intraoperative blood loss.The Mayo score was assessed 3 months after operation.The degree of motion of elbow joint,the time of fracture healing time and the incidence of complications were assessed 6 months after operation.Results The Mayo score of elbow joint 3 months after operation and the degree of motion of elbow joint 6 months after operation in 3D printing group were superior to those in the traditional surgery group(P<0.05).The operation time,the frequency of intraoperative fluoroscopy and the amount of bleeding during the operation in the 3D printing group were less than those in the traditional surgery group(P<0.05).There was no significant difference between the time of fracture healing and the incidence of complications(P >0.05).Conclusions In the treatment of distal humerus C-type fracture,3D printing fracture model can be used to assist the operation,which can achieve better clinical results.