3D打印技术结合桥接钢板系统治疗复杂髋臼骨折的临床比较研究

Computer Three-dimensional Imaging and 3D Printing Guide Open Acetabular Internal Fixation

目的:髋臼开放手术内固定是治疗复杂髋臼的金标准,计算机三维成像技术及3D打印技术能够指导术者做好手术规划,新型的骨折内固定材料同样为更好的完成手术提供便利.方法:本研究将我院2010年1月-2018年3月73例患者随机分配至重建钢板组(A组)、重建钢板结合3D打印组(B组)和桥接钢板系统结合3D打印组(C组),通过分析这3组病人手术时间、术中出血量、骨折复位的X线评价、骨折愈合时间、术后3、6、12个月的髋关节Charnley功能评分、其他术后并发症等结果,观察3D打印技术结合桥接钢板系统治疗复杂髋臼骨折的临床应用价值.结果:3组病人手术时间差异均有统计学意义;3D打印结合桥接钢板组出血量少于其它2组;3个月、6个月Charnley评分:3D桥接钢板组最高,3D重建钢板组次之,重建钢板组最低;12个月时Charnley评分差异无统计学意义.结论:3D打印明显提高了骨盆髋臼手术的效率和效果,桥接系统在手术操作和固定效果方面优于重建钢板.

Objective:Open acetabular internal fixation is the gold standard for the treatment of complex acetabular surgery.Computer three-dimensional imaging and 3D printing can guide the surgeon to do a good job in surgery planning.The new fracture internal fixation material also facilitates the completion of surgery.Methods:73 patients from January 2010 to March 2018 were randomly assigned to reconstruction plate group(group A)reconstruction plate combined with 3 D printing group(group B)and bridge plate system combined with 3 D printing group(group C).Through the analysis of the results of these three groups of patients,the amount of bleeding during surgery,the X-ray evaluation of fracture reduction,the time of fracture healing,the functional score of Chamley s hip joint after 3,6,and 12 months,and other postoperative complications.To observe the clinical value of 3D printing combined with bridge plate system in the treatment of complex acetabular fractures.Results:The difference of operation time between three groups of patients was statistically significant.The bleeding volume of 3 D printing combined with bridge plate group is less than that of other two groups.Chamley scored 3 months and 6 months:3 D bridged steel plate group was the highest,followed by 3D reconstructed steel plate group,and the reconstruction steel plate group was the lowest;The difference in Chamley scores at 12 months was not statistically significant.Conclusion:3D printing obviously improves the efficiency and effect of pelvic acetabular surgery.The bridge system is superior to the reconstruction plate in operation and fixation.