3D打印结合数字化设计在髋臼骨折手术治疗中的应用

The application of 3D printing combined with digital design in the surgical treatment of acetabular fracture

目的探讨3D打印结合数字化设计在髋臼骨折手术治疗中的应用。方法将58例髋臼骨折患者随机分为3D组和常规组,各29例。3D组采用3D打印结合数字化设计治疗,常规组采用常规内固定治疗。比较两组手术相关指标、骨折复位质量、Majeed评分优良率。结果3D组中,3D模型模拟手术、虚拟手术方案、临床手术中的置入钢板数量和位置均一致,置入螺钉的数量均一致,置钉方向偏差均较小。患者均获得随访,时间6~12个月。手术时间3D组短于常规组(P<0.05),术中出血量、术中输血量及术中透视次数3D组均少于常规组(P<0.05)。下地行走时间、术后6个月Majeed评分优良率以及Matta评分优良率两组比较差异均无统计学意义(P>0.05)。结论3D打印结合数字化设计用于髋臼骨折手术治疗可缩短手术时间,减少术中出血量及辐射量。

Objective To investigage the application of 3D printing combined with digital design in surgical treatment of acetabular fractures.Methods The 58 patients with acetabular fractures were randomly divided into 3D printing group and routine group,with 29 cases in each group.The 3D printing group was adopted 3D printing combined with digital design,and routine group was performed with routine internal fixation treatment.The surgery related indicators,quality of fracture reduction,excellent-good rate of Majeed score were compared between the two groups.Results In the 3D group,the number and postion of the plate placement in 3D model simulates operation,virtual operation plan and the clinical operation were consistent,and the number of screw placement in three methods were consistent,while the direction of the screws placement was less deviation.All cases were followed up for 6~12 months.The operation time of the 3D group was shorter than that of the routine group(P<0.05),and the intraoperative blood loss,intraoperative transfusion volume and fluoroscopy times were all lower than those of the routine group(P<0.05).The walking time and excellent-good rates of Majeed scores and Matta scores at postoperative 6 months had no differences between two groups(P>0.05).Conclusions The application of 3D printing combined with digital design in the surgical treatment of acetabular fractures can shorten the surgical time,and reduce intraoperative blood loss and radiation quantity.