3D打印技术在复杂骨盆骨折个体化治疗中的应用

Clinical application of 3D printing technology in the individualized treatment of complicated pelvic fractures

目的探讨个体化治疗复杂骨盆骨折运用3D打印技术的可行性及临床应用价值。方法以本院2015年7月至2018年7月收治的30例复杂骨盆骨折手术患者为研究对象,通过CT扫描得到的数据进行计算机三维建模,3D打印模型,研究制定手术方案,在模型上进行模拟手术,并针对拟用固定钢板进行预塑形,指导手术治疗。术后12个月骨盆骨折复位Matta评分及骨盆骨折功能Majeed评分作为术后随访评价标准。结果患者均随访12个月以上。手术时间65~150 min,平均(85.25±18.45)min;术中出血量400~1000 mL,平均(617.50±265.32)m L。切口均甲级愈合,未发生感染、神经损伤及深静脉血栓等并发症。骨盆骨折复位Matta评分:优22例,良6例,中2例,差0例,优良率93%。骨盆骨折功能Majeed评分:优24例,良3例,中3例,差0例,优良率90%。结论骨盆骨折治疗中应用3D打印技术可以全面、精确了解骨折形态,准确分型,个体化制定骨折手术治疗方案,有利于更好地进行术前评估及规划。

Objective To investigate the feasibility and clinical value of 3D printing technology in application of the individualized treatment of complicated pelvic fractures.Methods Thirty cases of patients with the complicated pelvic fracture surgery from July 2015 to July 2018 were selected as the research object.By using data obtained from CT scan for computer 3D modeling,3D printing was made and preoperatively previewed,so as to make the operation plan,operation simulation,preliminary shaping of fixed plate technique used in the guidance of surgical treatment.Postoperative follow up was measured in patients withMatta score and pelvic functionMajeed score at 12 months after operation.Results The patients were followed up for more than 12 months.The operation time was 65-150 min,averaging(85.25±18.45)min;intraoperative blood loss was 400-1000mL,averaging(617.50±265.32)mL.All incisions healed by first grade,no infection,no nerve injury and deep vein thrombosis.Pelvic fracture reduction was assessed according to the Matta score:Excellent in 22 cases,good in 6 cases,fair in 2 cases,poor in 0 case,the excellent and good rate was 93%.Pelvic fracture function evaluation was assessed according toMajeed score:Excellent in 24 cases,good in 3 cases,fair in 3 cases,poor in 0 case,the excellent and good rate was 90%.Conclusion 3D printing technology used in pelvic fracture can accurately understand the three-dimensional,fracture type,individualized surgical treatment of pelvic fractures,surgical simulation,is conducive to accurate fracture reduction and plate plastic,and be a better assessment and planning of pelvic fracture repair for preoperative preparation of pelvic fracture.