3D打印导航模板在股骨颈骨折辅助置钉中的应用研究

Application of 3D Printing Navigation Template in Auxiliary Screw Placement of Femoral Neck Fracture

目的研究在股骨颈骨折的内固定空心钉治疗中应用3D打印导航模板进行辅助置钉的效果。方法选取2020年1月-2021年1月经我院骨科临床确诊为股骨颈骨折的60例患者,均以空心钉内固定的术式进行治疗。根据螺钉置入方式的不同将患者分为对照组和观察组,每组30例。对照组在C型臂X线机透视下徒手进行置钉,观察组术中以3D导引导航模板辅助置钉。比较两组复位情况、手术时间、术中失血量、术中X线透视次数,同时对患者进行随访,统计末次随访的髋关节功能。结果对照组解剖复位、功能复位各有23例、7例,观察组各有25例、5例。观察组手术时间短于对照组[(36.89±8.61)min vs(65.11±12.40)min],差异有统计学意义(P<0.05);两组失血量比较,差异无统计学意义(P>0.05)。观察组术中X线透视次数少于对照组(6次vs 20次),差异有统计学意义(P<0.05)。两组均接受5~8个月的随访,末次随访时髋关节Harris评分比较,差异无统计学意义(P>0.05)。结论股骨颈骨折患者行空心螺钉内固定术治疗时,术中以3D打印导航模板辅助置钉,能实现手术操作精准化,减少手术操作时长,避免患者及医护长时间受X线辐射,提高了手术安全性。

Objective To study the effect of 3D printing navigation template for auxiliary nail placement in the treatment of femoral neck fracture with internal fixation hollow nail.Methods A total of 60 patients with femoral neck fracture diagnosed in department of orthopedics in our hospital from January 2020 to January 2021 were selected and treated with hollow nail internal fixation.According to the different screw placement methods,the patients were divided into control group and observation group,with 30 cases in each group.In the control group,the screw was placed by hand under the perspective of C-arm X-ray machine,and the observation group was assisted with 3 D navigation template.The reduction,operation time,intraoperative blood loss,and intraoperative X-ray fluoroscopy times were compared between the two groups.At the same time,the patients were followed up,and the hip function in the last follow-up was counted.Results There were 23 cases of anatomical reduction and 7 cases of functional reduction in the control group,and 25 cases and 5 cases in the observation group.The operation time in the observation group was shorter than that in the control group[(36.89±8.61)min vs(65.11±12.40)min],and the difference was statistically significant(P<0.05).There was no significant difference in blood loss between the two groups(P>0.05).The number of intraoperative X-ray fluoroscopy in the observation group was less than that in the control group(6 times vs 20 times),and the difference was statistically significant(P<0.05).The two groups were followed up for 5-8 months,and there was no significant difference in Harris hip score at the last follow-up(P>0.05).Conclusion In the treatment of femoral neck fracture patients with hollow screw fixation,3D printing navigation template is used to assist the placement of screws in the operation,which can achieve the accuracy of operation,reduce the operation time,avoid long-term X-ray radiation of patients and doctors,and improve the safety of operation.