3D打印技术辅助髂腹股沟入路治疗髋臼双柱骨折

3D Printing Assisted Ilioinguinal Approach for Surgical Treatment of Double Columns Acetabular Fractures

目的探讨3D打印技术辅助髂腹股沟入路治疗髋臼双柱骨折的临床疗效。方法回顾性分析2016年1月至2019年5月,我科应用3D打印技术辅助髂腹股沟入路治疗12例不伴后壁骨折的髋臼双柱骨折患者的临床资料,其中男9例,女3例;年龄24~70岁,平均(46.4±15.1)岁。记录手术时间、出血量、并发症等情况。术前3D打印骨盆模型、模拟手术并预弯钢板。术后以Matta标准评估骨折复位情况,改良的Merle D’Aubigne和Postel评分系统评估髋关节功能情况。结果患者均顺利完成手术。手术时间130~245 min,术中出血量600~1600 mL,自体血回输300~800 mL。随访0.5~2.5年,平均(1.5±0.7)年,患者全部骨性愈合。术后骨折复位质量评估,优6例,良4例,可2例,优良率83.3%;髋关节功能评估:优5例,良4例,可3例,优良率75.0%。结论3D打印技术可辅助髂腹股沟入路精准个性化复位固定髋臼双柱骨折,疗效好,是一种理想的方法。

Objective To analysis the clinical results and superiority of three-dimensional printing assisted ilioinguinal approach in the treatment of double columns acetabularfractures.Methods A retrospective analysis was made on 12 patients with double columns acetabular fractures treated by 3 D printing combined with single anterior approach from Jan,2016 to May,2019.There were 9 males and 3 females,with an average of(46.4±15.1)years(range:24 to 70 years).Preoperative3 D printing of pelvic model and simulated surgery and pre-bending plates were applied.During the operation,the fractures were reduced and fixed with plates and screws via the ilioinguinal approach.The patients’operationtime,intraoperative blood loss and complications were recorded.The Matta evaluation criteria was used to assess fracture reduction and the modified Merle D’Aubigneand Postel scoring systemwas used for evaluating hip functionin patients.Results All patients were completed the operationsuccessfully.The operationtime was 130~245 min,the amount of bleeding was 600~1600 mL,the autotransfusion volume was 300~800 mL.Followed up ranged form 0.5 to 2.5 years,with an average of(1.5±0.7)years,all the fractures healed.Postoperative X-ray filmswere evaluated according to Matta imaging criteria:excellent in 6 cases,good in 4 cases,fair in 2 cases,and the excellent and good rate was 83.3%.Postoperative hip function was evaluated according to modified Merle d’Aubigne and Postel criteria:excellentin 5 cases,good in 4 cases,fair in 3 cases,and the excellent and good rate was 75.0%.Conclusion 3 D printing technique assisted ilioinguinal approach is feasible for double columns acetabular fracture.It can make accurate individualized reduction and fixation for fracture,has good efficacy.