计算机辅助测量联合3D打印技术在Taylor空间支架治疗小腿畸形中的应用

Application of Taylor spatial frame with computer assisted measurement combined with 3D printing in the treatment of tibial deformity

目的探讨运用计算机辅助测量联合3D打印技术在Taylor空间支架治疗小腿畸形中的可行性及临床效果。方法回顾性分析2016年5月至2018年10月在福建中医药大学附属厦门第三医院运用Taylor空间支架治疗小腿畸形的6例病人的临床资料。通过CT薄层扫描,3D打印技术制作骨模型和截骨导板。根据Taylor空间支架配套软件所需参数应用Mimics软件进行测量,按照配套软件的规划在3D打印模型验证矫形结果。术后参照Johner-Wruhs评定标准进行患肢功能评价。结果 6例病人均获得随访,随访时间为9~25个月,平均15.2个月。其中1例钉道感染,未发生神经、血管损伤和骨不连。拆除外固定时间为12~16周,平均13.7周。术后患肢无跛行。末次随访按照Johner-Wruhs评定标准,优5例,良1例。结论计算机辅助测量联合3D打印技术在Taylor空间支架治疗小腿畸形中可获得良好的临床疗效,并具有测量准确,截骨精确,矫形精准,调整方便等优势,是小腿复杂畸形精准化矫形的有效治疗方法。

Objective To evaluate effectiveness and outcomes of computer assisted measurement combined with 3 D printing of Taylor spatial frame for treatment of tibial deformity. Methods From May 2016 to October 2018, 6 patients with tibial deformity were treated with Taylor spatial frame in Xiamen Third Hospital, Fujian University of Traditional Chinese Medicine. The 3 D modeling and custom-made surgical guide were printed based on a three-dimensional computer tomography. The software of Taylor spatial frame was established according to the data obtained from Mimics software, and postoperative rehearsal was performed on3 D printed models for checking the result of deformity correction. The function of the affected limb was evaluated by Johner-Wruhs standard after operation. Results Six patients were followed up for an average of15.2 months(from 9 to 25 months). All patients obtained the fracture healing without neurovascular injury.There was 1 case of pin infection. The stent removal time was 12-16 weeks(mean, 13.7 weeks). According to the Johner-Wruhs standard, the results were excellent in 5 cases, and good in 1 case. Conclusion Computer assisted measurement and 3 D printing of Taylor spatial frame for treatment of tibial deformity can provide accurate cutting, measurement and deformity correction, which is relatively effective and precise.