3D打印技术辅助治疗复杂髋臼骨折的疗效研究

Study on the curative effect of assisted 3D printing technique in treating complex acetabular fracture

目的:探究三维(3D)打印技术辅助治疗复杂髋臼骨折的疗效。方法:选取在医院就诊的42例复杂髋臼骨折患者,将采用常规手术方法治疗的22例患者纳入常规组,采用3D打印辅助手术治疗的20例患者纳入3D组。应用髋臼骨折复位标准Matta评分、改良MerleD’Aubigne和Postel功能评分,评价两组患者在手术时间、术中出血量、手术固定效果、髋关节术后功能恢复及不良反应等相关情况。结果:3D组患者手术时间及术中出血量均低于常规组,两组手术情况比较差异有统计学意义(t=11.040,t=7.180;P<0.05);以Matta标准评价患者术后骨折复位效果,两组患者复位优良率比较,差异无统计学意义(x^2=0.760,P>0.05);术后3个月改良Merle D’Aubigne和Postel评分中,3D组患者髋关节功能恢复优良率明显高于常规组,其差异有统计学意义(x^2=5.780,P<0.05),手术后1年两组患者髋关节功能恢复情况无明显差别;常规组和3D组并发症发生率分别为13.6%和5%,无明显差别。结论:3D打印技术辅助手术治疗复杂髋臼骨折,通过术前制作患者手术部位3D打印模型,辅助进行手术方案的制定和预演,能够缩短手术时间,减少术中出血量,加快患者髋关节功能的恢复,具有较好的临床应用前景。

Objective: To explore the curative effect of assisted three-dimensional(3 D) printing technique in treating complex acetabular fractures. Methods: 42 patients with complex acetabular fractures were selected. And 22 patients who were treated with conventional surgery were divided into conventional group, and 20 patients who were treated with assisted 3 D printing surgery were divided into 3 D group. The operative time, intraoperative bleeding, fixation effect of operation, postoperatively functional recovery and adverse reactions of the two groups were evaluated by using the standard Matta score of the reduction of acetabular fracture, modified Merle D’Aubigne and Postel functional score. Results: The operation time and intraoperative blood loss of 3 D group were significantly lower than those of conventional group(t=11.040, t=7.180, P<0.05). There was no significant difference in the excellent and good rate of reduction as Matta standard between the two groups(x^2=0.760, P>0.05). In the modified Merle D’Aubigne and Postel scores at 3 th month post-operation, the excellent and good rate of functional recovery of hip joint of 3 D group was significantly higher than that of conventional group(x^2=5.780, P<0.05). There was no significant difference in the recovery of function of hip joint between the two groups at one year after operation. The incidences of complications in conventional group and 3 D group were 13.6% and 5%, respectively. Conclusion: The treatment of surgery with assisted 3 D printing technique for complex acetabular fractures can associate to formulate and preview surgical scheme through makes the model of 3 D printing of surgical site before surgery. It can shorten the time of operation, reduce intraoperative amount of bleeding, and accelerate the recovery of the function of hip joint of patient. It has better clinical application prospect.