3D打印模型在高能量关节内骨折手术中的应用

Application of 3D printing model in surgery for high-energy intra-articular fracture

目的探讨3D打印模型治疗高能量关节内骨折手术患者的效果。方法选取2017年12月~2018年12月我院接受诊疗的40例高能量关节内骨折患者为研究对象,按入院床位的奇、偶数分为对照组(n=20)与观察组(n=20)。对照组采用常规切开复位异形钢板内固定术,观察组在术前通过3D打印技术打印出高能量关节骨折模型,后根据模型设计个体化手术方案。比较两组的手术临床指标,术后随访12个月,比较其康复情况、关节功能,并记录并发症发生情况。结果观察组的手术时间短于对照组,术中出血量少于对照组,差异均有统计学意义(P<0.05);随时间推移,两组的术后肿胀程度、视觉模拟量表(VAS)评分越来越低,负重情况评分越来越高;术后1、3、6及12个月,观察组的肿胀程度、VAS评分低于对照组,负重情况评分高于对照组,差异均有统计学意义(P<0.05);随时间推移,两组的关节功能评分越来越高,术后1、3、6及12个月,观察组的关节功能评分高于对照组,差异有统计学意义(P<0.05);两组的并发症总发生率比较,差异无统计学意义(P>0.05)。结论3D打印模型辅助治疗高能量关节内骨折手术患者,可有效缩短患者手术时间,减少术中出血量,促进机体康复,提高关节功能恢复,且不会增加并发症的发生率。

Objective To explore the effect of 3D printing model on the treatment of patients with high energy intra-articular fracture surgery.Methods A total of 40 patients with high-energy intra-articular fracture who were treated in our hospital from December 2017 to December 2018 were selected as the research subjects.All the patients were divided into control group and observation group according to the odd and even numbers of beds on admission,20 cases in each group.The control group underwent routine open reduction and special-shaped plate internal fixation,and 3D printing technology was used to print high-energy joint fracture model in observation group before surgery,and then the individualized surgical plan was designed based on the model.The clinical surgical indexes were compared between the two groups.The rehabilitation and ankle joint function were compared between the two groups after 12 months of postoperative follow-up,and the incidence of complications was recorded.Results The operation time of the observation group was shorter than that of the control group,and the intraoperative blood loss was less than that of the control group,the differences were statistically significant(P<0.05)As time went by,the postoperative swelling degree and visual analogue scale(VAS)score of the two selected groups became lower and lower,and the weight bearing situation became better and better;After surgery for 1,3,6 and 12 months,the swelling degree and VAS score of observation group were lower than those of the control group,and the weight-bearing score was higher than that of the control group,the differences were statistically significant(P<0.05).As time went by,the joint function scores of the two groups of candidates were getting higher and higher.The scores of joint function in observation group were higher than those of the control group after surgery for 1,3,6 and 12 months,the differences were statistically significant(P<0.05).There was no statistically significant difference between the two groups in the total incidence of complications(P>0.05).Conclusion 3D printing model in treatment of patients with high-energy intra-articular fracture surgery can shorten operation time,reduce intraoperative bleeding volume,promote rehabilitation,enhance recovery of joint function,and not increase complications.