3D打印导板应用在后环骶髂螺钉联合经皮骨盆前环内支架固定技术固定TileB2型骨盆骨折的疗效分析

Efficacy analysis of 3D printing guide plate in posterior ring sacroiliac screw combined with anterior ring subcutaneous infix fixation of Tile B2 pelvic fracture

目的分析后环跨骶骨的髂骨间钢板联合前环骨盆外固定架固定技术与后环骶髂螺钉联合经皮骨盆前环内支架固定(INFIX)技术治疗TileB2型骨盆骨折的效果。方法收集TileB2型骨盆骨折患者43例患者资料,分为2组,使用后环跨骶骨的髂骨间钢板联合前环骨盆外固定架固定为对照组,使用后环骶髂螺钉联合经皮INFIX固定为实验组,对照组25例,实验组18例。采用Matta标准以及Majeed评分方法,对比分析患者术后疗效。结果手术切口实验组较对照组小,差异有统计学意义(P<0.05)。手术时间实验组长于对照组,差异有统计学意义(P<0.05)。实验组复位质量优于对照组(P<0.05),末次随访术后功能恢复评分与对照组比较无统计学意义(P>0.05),实验组较对照组术后并发症少(P<0.05)。结论应用3D打印导板技术行后环骶髂螺钉联合前环皮下INFIX固定TileB2型骨盆骨折手术切口小、出血少、复位质量高,术后并发症少。

Objective To compare the efficacy of posterior ring transsacral interiliac plate combined with anterior ring pelvic external fixator(control group)and posterior ring sacroiliac screw combined with anterior ring subcutaneous INFIX(experimental group)in the treatment of Tile B2 pelvic fractures.Methods The data of 43 patients with Tile B2 pelvic fracture were retrospectively analyzed.The perioperative incision length,operation time,intraoperative bleeding,hospital stay,postoperative spontaneous functional exercise time,fracture reduction(Matta criteria),postoperative fracture recovery(Majeed score)and postoperative complications were compared.Results There were 25 cases in the control group,of which 3 cases had incision infection and 1 case had pin tract infection.One plate and screw loosened and backed out,and eight frame screws loosened.All patients were cured after 1 month of operation.The surgical incision in the experimental group was smaller than that in the control group,and the difference had statistical significance(P<0.05).The operation time in the test group was longer than that in the control group,and the difference had statistical significance(P<0.05).The reduction quality of the experimental group was better than that of the control group(P<0.05).The postoperative functional recovery score of the experimental group was not statistically different from that of the control group(P>0.05).The experimental group had fewer postoperative complications than the control group(P<0.05).Conclusion Posterior circumferential sacroiliac screws combined with anterior circumferential subcutaneous INFIX fixation of Tile B2 pelvic fractures using 3D printed guide technique has the advantages of small incision,less bleeding,high reduction quality and less postoperative complications.It is worthy of promotion in clinical practice.