3D打印技术下空心螺钉微创固定对Tile B型骨盆骨折的近期疗效及并发症的影响

Effect of minimally invasive fixation of cannulated screws on the short-term effect and complications of Tile B-type pelvic fractures with 3D printing

目的探讨3D打印技术辅助空心螺钉微创固定对Tile B型骨盆骨折的近期疗效及并发症的影响。方法前瞻性研究2015年6月-2018年6月河南省漯河市医专二附院收治的Tile B型骨盆骨折患者124例,随机数字表法分成空心螺钉组和3D组,各62例。空心螺钉组应用空心螺钉微创固定,3D组在3D打印技术下进行空心螺钉微创固定。比较两组患者骨折复位质量、术中情况、并发症发生情况、伤口愈合时间、病死率、功能恢复时间。结果3D组优良率96.8%,空心螺钉组优良率80.6%,3D组患者的骨折复位质量显著优于空心螺钉组(P<0.05)。3D组手术时间(57.2±13.2)min、术中透视次数(28.1±3.1)次、术后骨折愈合时间(13.8±1.5)周,空心螺钉组手术时间(71.3±11.4)min、术中透视次数(35.9±3.2)次、术后骨折愈合时间(13.5±2.0)周;3D组手术时间与术中透视次数显著少于空心螺钉组(P<0.05),术后骨折愈合时间与空心螺钉组比较,差异无统计学意义(P>0.05)。3D组并发症发生率6.4%,显著低于空心螺钉组24.1%(P<0.05);3D组伤口愈合时间(5.1±1.8)d、病死率1.6%、功能恢复时间(4.6±1.5)个月,空心螺钉组伤口愈合时间(7.5±2.2)d、病死率8.1%、功能恢复时间(5.7±1.4)个月,3D组伤口愈合时间、功能恢复时间早于空心螺钉组(P<0.05),病死率低于空心螺钉组(P<0.05)。结论3D打印技术下对Tile B型骨盆骨折患者应用空心螺钉微创固定,有助于提高疗效,减少手术时间,降低术后并发症发生率,值得在临床上推广应用。

Objective To investigate the short-term effect and minimally invasive fixation of cannulated screws on Tile B type pelvic fractures with 3 D printing technique.Methods Totally 124 patients with Tile B pelvic fractures admitted to our hospital from Jun.2015 to Jun.2018 were selected.They were randomly divided into two groups with 62 cases in each group.The control group was treated with minimally invasive fixation with cannulated screws.The study group underwent minimally invasive fixation with cannulated screws under 3 D printing technique.The fracture reduction quality,intraoperative conditions,complications,and fracture healing time,mortality,and functional recovery time were compared between the two groups.Results The excellent and good rate of the study group was 96.8%,and the excellent and good rate of the control group was 80.6%.The fracture reduction quality of the study group was significantly better than that of the control group(P<0.05).The operation time of the study group was 57.2±13.2 min,the intraoperative fluoroscopy times was 28.1±3.1,the postoperative fracture healing time was 13.8±1.5 weeks,while the operation time of the control group was 71.3±11.4 min,the fluoroscopy times was 35.9±3.2 times,and the postoperative fracture healing time was 13.5±2.0 weeks.The operation time and intraoperative fluoroscopy times of the study group were significantly less than those of the control group(P<0.05).There was no significant difference in the fracture healing time between the study group and the control group(P>0.05).The complication rate of the study group was 6.4%,and the complication rate of the control group was 24.1%.The postoperative complication rate of the study group was significantly lower than that of the control group(P<0.05).The wound healing time of the study group was 5.1±1.8 d and the mortality rate was 1.6%.The function recovery time was 4.6±1.5 months.The wound healing time of the control group was 7.5±2.2 days,the mortality rate was 8.1%,and the functional recovery time was 5.7±1.4 months.The wound healing time and functional recovery time of the study group were less than the control group(P<0.05),the mortality rate of the study group was lower than the control group(P<0.05).Conclusion The minimally invasive fixation of cannulated screws in patients with Tile B type pelvic fracture under 3 D printing technology can improve the curative effect,reduce the operation time and reduce the incidence of postoperative complications.It is worthy of clinical application.