数字设计与3D打印辅助手术治疗髋臼骨折

Digital design and three-dimensional printing assisted procedure for acetabular fractures

[目的]介绍Mimics软件数字化设计结合3D打印模型辅助手术治疗髋臼粉碎性骨折的技术。[方法]对6例患者应用数字化设计、3D打印模型辅助手术:3D重建髋臼骨折模型、骨折块分割及复位、挑选匹配最佳的钢板、3D打印1:1的实体模型、模型骨折复位及预弯钢板、按术前规划手术。根据Matta影像学评估标准评价骨折复位质量,采用Merle D'Aubigne and Postel评分评定髋关节功能。[结果]6例患者均顺利完成手术,手术时间(139.53±34.25)min,术中失血量(310.91±111.73)ml,术中无血管、神经损伤等严重并发症。术后随访6~17个月,骨折均愈合。末次随访时,按Matta标准评定,骨折复位优良率为83.33%(5/6),按Merle D'Aubigne and Postel评分标准,髋关节功能优良率为66.67%(4/6)。[结论]数字化术前设计结合3D打印技术术前模拟实现了粉碎性髋臼骨折的个体化、精准化治疗。

[Objective]To introduce the technique of digital design using Mimic software and 3D printing models for internal fixations of comminuted acetabular fractures.[Methods]A total of 6 patients underwent open reduction and internal fixationassisted by digital design and 3D printing models for acetabular fractures.A reconstructed three-dimensional model of pelvis was created based on CT scanning.Virtual fracture reduction was conducted,and internal fixation with the selected optimal matching plate was performed using Mimic software.Furthermore,a 3D-printed 1:1 real model was printed,fracture reductions and internal fixation with the pre-shaped plates was individually simulated on the model before surgery.Finally,the surgical procedure was performed according to the preoperative plan.The fracture reduction results were assessed by using Matta criteria,while the hip function was evaluated by Merle D'Aubignèand Postel score.[Results]All the 6 patients had surgical operations performed successfully with operation time of(139.53±34.25)min and intraoperative blood loss of(310.91±111.73)ml.No serious complication,such as neurovascular injuries,occurred in anyone of them.All patients obtained bony union in the followed-up period of 6~17 months.At the latest follow up,the excellent and good rate of fracture reduction was of 83.3%(5/6)based the Matta criteria,while the excellent and good rate of hip function was of 66.7%(4/6)according to Merle D'Aubignèand Postel scores.[Conclusion]This digital design and three-dimensional printing models realize the individual and precise treatment for acetabular fractures.