3D打印技术在复杂胫骨平台骨折手术中的应用

The application of 3D printing technique in the treatment of complicated tibial plateau fractures

目的探讨3D打印技术在复杂胫骨平台骨折手术中应用的可行性。方法应用3D打印技术治疗59例SchatzkerⅣ～Ⅵ型胫骨平台骨折患者。术前行膝关节三维CT重建,应用3D技术打印实体模型,在模型上进行手术设计并模拟手术,术中按术前设计手术。结果患者均获得随访,时间12～24个月。患者均获得骨性愈合,无胫骨平台二次塌陷、内固定松动断裂、骨不连等并发症发生。术后第5天膝关节X线片显示解剖复位51例,移位<1 mm 5例,移位> 1 mm 3例,解剖复位率86. 4%。术后12个月根据膝关节HSS评分评价疗效:优38例,良12例,可9例,优良率为84. 7%。结论在复杂胫骨平台骨折治疗中应用3D打印技术,对手术方案进行个体化设计,指导手术操作,可有效提高骨折复位质量。

Objective To explore the feasibility of 3D printing technique in the application of complex tibial plateau fractures. Methods A total of 59 patients with Schatzker type Ⅳ~Ⅵ tibial plateau fractures were treated with 3D printing technique. All patients underwent 3D CT reconstruction of the knee before operation. The solid model was printed by 3D technique, and the operation design and simulation were performed on the model. Results All patients were followed up for 12~24 months. All patients were bony healing, and no complications such as secondary collapse of the tibial plateau, loosening of internal fixation, and nonunion of the bone occurred. On the 5th day after operation, the radiographs of the knee joint showed 51 cases of anatomical reduction, 5 cases of displacement <1 mm, 3 cases of displacement >1 mm, anatomic reduction rate of 86.4%;at 12 months after operation,HSS evaluation of the knee joint was excellent in 38 cases, good 12 cases, and fair 9 cases, the excellent and good rate was 84.7%. Conclusions 3D printing technique in the treatment of complex tibial plateau fractures can be used to improve the quality of fracture reduction.