3D打印技术辅助单一前入路治疗髋臼双柱骨折

3-D Printing Assisted Single Anterior Approach for Surgical Treatment of Double Columns Acetabular Fractures

目的:探讨3D打印技术辅助单一前入路治疗髋臼双柱骨折的可行性及临床疗效。方法:回顾性分析19例采用3D打印技术辅助单一前入路复位内固定的髋臼双柱骨折患者。术前3D打印骨盆模型、模拟手术并预弯钢板。采用腹直肌外侧入路8例,髂腹股沟入路11例。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100~235min,术中出血量450~1600ml,自体血回输200~800ml。随访0.5~2.5年,全部骨性愈合。术后骨折复位质量评估:优7例,良9例,可3例,优良率84.2%;髋关节功能评估:优6例,良9例,可4例,优良率78.9%。结论:3D打印技术可辅助前入路精整个性化复位固定髋臼双柱骨折,尤其是腹直肌外侧入路,操作方便、创伤少、疗效好,是一种理想的方法。

Objective:To analysis the clinical results and superiority of three-dimensional printing assisted single anterior approach in the treatment of double columns acetabular fractures.Methods:A retrospective analysis was made on 19 patients with double columns acetabular fractures treated by 3D printing combined with single anterior approach.Preoperative 3D 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 screwes via the lateral rectus abdominis approach or lioinguinal approach.The Matta evaluation criteria was used to assess fracture reduction and the modified Merle D’Aubigne and Postel scoring system was used for evaluating hip function in patients.Results:All patients were completed the operation successfully.The operation time was 100~235 minutes,the amount of bleeding was 450~1600ml,autotransfusion 200~800ml.Followed up for 0.5~2.5 years,all the fractures healed.Postoperative X-ray films were evaluated according to Matta imaging criteria:excellent in 7 cases,good in 9 cases,fair in 3 cases,and the excellent and good rate was 84.2%.Postoperative hip function was evaluated according to modified Merle D’Aubigne and Postel criteria:excellent in 6 cases,good in 9 cases,fair in 4 cases,and the excellent and good rate was 78.9%.Conclusion:3D printing technique assisted single anterior approach is feasible for double columns acetabular fracture.It can make accurate individualized reduction and fixation for fracture.Especially via the lateral rectus abdominis approach,has advantages of easy operation,less invasion and good efficacy,is worthy recommending.