3D打印导板辅助成人肘内翻畸形截骨矫正

3D printed guider assisted osteotomy for correction of cubitus varus deformity in adult

[目的]探讨3D打印导板辅助成人肘内翻畸形矫正的临床疗效。[方法]回顾性分析2011年1月—2017年12月在我院行截骨矫形、钢板内固定的25例成人肘内翻患者的临床资料。其中,14例采用传统方法进行截骨矫形钢板内固定(传统组),11例采用个性化3D打印导板辅助截骨矫形钢板内固定(导板板)。比较两组围手术期、随访与影像资料。[结果]两组患者均顺利完成手术,术中均无桡神经损伤。导板组手术时间、术中失血量均显著优于传统组,差异有统计学意义(P<0.05)。导板组恢复完全负重活动时间早于传统组,但差异无统计学意义(P>0.05)。相应时间点,两组间Mayo肘关节功能评分的差异均无统计学意义(P>0.05)。影像方面,末次随访时,导板组的提携角显著大于传统组(P<0.05)。两组截骨处均骨性愈合,两组截骨愈合时间的差异无统计学意义(P>0.05)。[结论]与传统截骨方法相比,3D打印截骨导板辅助肘内翻畸形截骨的手术疗效相当,但可明显减少手术时间、出血量并获得更为理想的术后提携角。

[Objective] To explore the clinical outcomes of 3 D printed guider assisted osteotomy for correction of cubitus varus deformity in adult. [Methods] A retrospective study was conducted on 25 adult patients who underwent humeral supracondylar osteotomy for correction of cubitus varus deformity in our hospital from January 2011 to December 2017. Among them, 14 patients received traditional osteotomy and internal fixation with plate, while the remaining 11 patients had osteotomy and internal fixation performed with assistance of personalized 3 D printed guider. The perioperative period, follow-up and imaging data were compared between the two groups. [Results] The patients in both groups were operated on smoothly, without radial nerve injury during the operation. The guider group was significantly better than the traditional group in terms of operation time and intraoperative blood loss, which was statistically significant(P<0.05). The guider group resumed full weight-bearing activities earlier than the traditional group, but the difference was not statistically significant(P>0.05). At the corresponding time point, there was no statistically significant difference in MEPS scores between the two groups(P>0.05).In terms of imaging evaluation, the guider group had significantly greater carrying angle than the traditional group at the latest follow-up(P<0.05). In addition, the osteotomy sites healed in all patients with no significant difference in the healing time between the two groups(P>0.05). [Conclusion] Compared with the traditional osteotomy technique, the 3 D printed guider assisted osteotomy for correction of cubitus varus deformity does have the same curative efficiency, but this individualized technique significantly reduce the operation time, blood loss and obtain a more ideal postoperative carrying angle.