3D打印辅助锁骨骨折微创内固定治疗

3D printing-assisted minimally invasive internal fixation for clavicle fracture

目的研究个体化3D打印模型对钢板进行预塑形对锁骨中段骨折手术的益处。方法选取2018年10月—2019年10月手术治疗的锁骨中段骨折30例病例资料。根据患者是否采用3D打印技术辅助手术分为3D打印组和非3D打印组。统计并比较两组手术时间、术中透视次数,术中出血量、术中更换螺钉次数及术后DASH评分,并发症发生率。结果手术时间:3D打印组(42.07±8.34)min;非3D打印组(56.60±7.69)min。术中出血量:3D打印组(39.53±4.03)mL;非3D打印组(66.27±5.97)mL。术中透视:3D打印组(2.80±1.32)次;非3D打印组(6.47±1.55)次。术中更换螺钉:3D打印组(0.40±0.63)次;非3D打印组(1.13±0.64)次。6周随访时,DASH评分:3D打印组为(10.80±2.73)分,非3D打印组为(14.73±2.99)分。组间差异均有统计学意义。3D打印组患者术后未出现并发症,非3D打印组患者术后有2例出现内固定激惹。结论3D打印技术能减少微创锁骨内固定手术时间、螺钉更换次数,改善术后早期肩关节功能。

Objective To investigate the advantages of pre-shaped plate based on 3D printing model in the surgery for clavicle fracture.Methods From October 2018 to October 2019,the medical records of 30 cases of midshaft clavicle fracture were retrieved.The patients were divided into an experimental group and a control group according to whether 3D printing-assisted technology was used or not.The operation time,intraoperative fluoroscopy times,intraoperative blood loss,intraoperative screw replacement times,postoperative DASH score,and complication rate of the two groups were compared.Results The operation time of the experimental group was(42.07±8.34)min,while that of the control group was(56.60±7.69)min.The intraoperative blood loss was(39.53±4.03)mL in the experimental group and(66.27±5.97)mL in the control group.The intraoperative fluoroscopy frequency was(2.80±1.32)times in the experimental group and(6.47±1.55)times in the control group.In the experimental group,the screws were replaced(0.40±0.63)times,while in the control group,the number was(1.13±0.64)times.At the follow-up visit 6 weeks after surgery,the DASH score of the experimental group was 10.80±2.73,and that of the control group was 14.73±2.99.All these indicators between the two groups were significantly different.There were no postoperative complications in the experimental group,and 2 cases in the control group had internal fixation irritation.Conclusion Applying 3D printing technology can reduce the time of minimally invasive fixation and screw replacement frequency,and improve postoperative early shoulder function.