金属3D打印定制化人工全腕关节置换术临床应用的观察

Total wrist arthroplasty by three-dimensional printed customized prosthesis:a case report

目的观察金属3D打印定制化人工全腕关节假体的临床应用疗效。方法2020年11月3日北京积水潭医院手外科对非特异性腕关节炎的患者采用金属3D打印的定制化人工腕关节假体行全腕关节置换术。术后6周进行临床功能随访,评价指标包括腕关节活动度,视觉模拟评分法(VAS)评分,上肢功能障碍评分简略版(quick DASH)以及患者自评腕关节评价量表(PRWE)评分。结果患者术后6周可恢复主动屈伸活动42°,旋转活动基本同术前。VAS评分由3分降到术后0分。quick DASH与术前一致,PRWE术后因两项动作无法完成而无法统计。结论金属3D打印定制化人工全腕关节假体具有一定的可操作性,可明显减轻患者疼痛,并获得一定的主动活动度,具有临床推广的价值。

Objective To explore the possibility of clinical application of metal 3D printing customized total wrist prosthesis.Methods On November 3rd,2020,a patient who was clinically diagnosed with non-specific wrist arthritis was treated with a metal 3D printed customized total wrist prosthesis for total wrist arthroplasty(TWA)in Department of Hand Surgery,Beijing Jishuitan Hospital.Clinical function follow-up was performed 6 weeks after surgery.Evaluation indicators include wrist range of motion(ROM),visual analogue scale(VAS)score,the quick disabilities of the arm,shoulder and hand(quick DASH)and the patient-rated wrist evaluation(PRWE).Results The patient was able to resume active total flexion and extension for 42°at 6 weeks after surgery;and the rotation activities were as the same as before.The VAS score dropped from 3 points to 0 point after surgery.Quick DASH is the same as before operation.As for PRWE,it cannot be counted because two actions can not be completed.Conclusion The metal 3D printing customized total wrist joint prosthesis has a certain degree of application chance.After TWA,the pain can significantly be reduced,and the patient may obtain a ROM for daily life.It is worthful for the clinical promotion.