3D打印技术辅助腹直肌旁入路治疗复杂髋臼骨折疗效分析

Analysis of the Effect of 3D Printing Technology in the Treatment of Complex Acetabular Fracture

目的:探讨3D打印技术辅助腹直肌旁入路治疗复杂髋臼骨折的疗效及安全性。方法:自2015年3月-2018年6月在我院治疗的32例复杂髋臼骨折患者为研究对象,按照随机分组原则分为观察组与对照组,观察组21例,对照组11例。对照组采用常规X线及CT行手术设计,观察组采用3D打印技术进行手术设计,二组均采用腹直肌旁入路手术治疗,比较两组的手术时间、切口长度、术中出血量及骨折复位质量、临床功能评价。结果:术后随访时间37.9月(12~47月),本组病例均无严重并发症发生。观察组与对照组术后3个月的骨折复位质量优良率分别为95.23%和90.91%,差异无统计学意义(P>0.05)。观察组与对照组术后3个月的临床功能评价优良率分别为97.22%和75.73%,观察组的术后功能优良率明显高于对照组(P<0.05)。两组患者手术切口长度差异无统计学意义(P>0.05),观察组的术中出血量与手术时间明显少于对照组(P<0.05)。结论:对于复杂髋臼骨折,通过3D打印辅助腹直肌旁入路,能得到满意的显露及复位固定,且切口损伤及术后并发症较小。

Objective To investigate the clinical efficacy and safety of 3 D printing technology in the treatment of complex acetabular fractures. Methods From March 2015 to June 2018, 32 cases of complex acetabular fractures were selected as the research object. All the patients were divided into the observation group and the control group, 21 cases in the observation group and 11 cases in the control group. The control group was given conventional X-ray and CT operation design, the observation group was given the 3 D printing technology operation design, and both groups were given lateral-rectus approach surgical treatment. The operation time, incision length and intraoperative blood loss, fracture reduction quality and clinical function evaluation of the two groups were compared. Results All patients were followed up for 12~47 months(mean, 37.9 months). The results revealed that there were no serious complications occurred in both groups. The excellent and good rates of fracture reduction in the observation group and the control group at 3 months after operation were 95.23% and 90.91%, respectively, and the difference between the two groups was not statistically significant(P>0.05). The excellent and good rates of clinical outcome in the observation group and the control group at 3 months after operation were 97.22% and 75.73%, respectively, which was significantly higher in the observation group than that in the control group(P<0.05). There was no significant difference in incision length between the two groups(P>0.05). The amount of bleeding and operation time in the observation group were significantly less than those in the control group(P<0.05). Conclusion The 3 D printing technique assisted lateral-rectus approach for the treatment of complex acetabular fractures can obtain satisfactory exposure, reduction and fixation, with less incision damage and postoperative complications.