三维打印技术结合掌侧入路T型钢板内固定对桡骨远端骨折病人的临床疗效

Clinical effects of 3D printing technology combined with T-plate internal fixation via palmar approach on patients with distal radius fracture

目的探究三维打印(3D打印)技术结合掌侧入路T型钢板内固定对桡骨远端骨折的临床疗效。方法选取2017年1月至2019年10月在武汉市普仁医院就诊的桡骨远端骨折病人120例,采用随机数字表法将病人分为联合组和单一组各60例,单一组进行掌侧入路T型钢板内固定治疗,联合组行3D打印技术结合掌侧入路T型钢板内固定治疗,术后第4周进行疗效评价,比较两组病人临床疗效、肢体肿胀程度、数字疼痛评分法(NPRS)评分、骨折愈合评分系统(RUSS)评分及腕关节功能Cooney评分变化情况。结果联合组总体临床疗效明显高于单一组(P<0.05);联合组总有效率(95.00%)也明显高于单一组(81.67%)(P<0.05);联合组NPRS评分[(2.51±1.04)分比(3.06±0.84)分]、肢体肿胀程度[(6.67±2.24)%比(7.62±1.96)%]均显著低于单一组(P<0.05);两组病人治疗后不同时间点骨折愈合RUSS评分比较差异有统计学意义(P<0.05);两组间骨折愈合RUSS评分比较差异有统计学意义(P<0.05),但两组间与各个时间点不存在交互作用(P>0.05)。两组Cooney评分均较术前提高,联合组显著高于单一组(P<0.05)。结论3D打印技术结合掌侧入路T型钢板内固定治疗桡骨远端骨折疗效显著,骨折复位良好,可显著缓解病人疼痛及肢体肿胀症状,提高术后腕关节功能的恢复,值得临床推广应用。

Objective To explore the clinical effects of three-dimensional(3D)printing technology combined with T-plate internal fixation via palmar approach on distal radius fracture.Methods A total of 120 patients with distal radius fracture treated in Wuhan Puren Hospital from January 2017 to October 2019 were selected and randomized into combined treatment group and single treatment group,with 60 cases in each group.The single treatment group was treated with T-plate internal fixation via palmar approach,while the combined treatment group was treated with 3D printing technology combined with T-plate internal fixation via palmar approach,.The clinical effects,the degree of limb swelling,the scores of numerical pain rating scale(NPRS),radiusunion scoring system(RUSS)and Cooney were compared between the two groups.Results The overall clinical effects of the combined treatment group was significantly higher than that of the single treatment group(P<0.05);the total effective rate of the combined treatment groupwas also significantly higher than that of the single treatment group(95.00%vs.81.67%,P<0.05).The NPRS score[(2.51±1.04)points vs.(3.06±0.84)points]and the degree of limb swelling[(6.67±2.24)%vs.(7.62±1.96)%]of the combined treatment group were significantly lower than those of the single treatment group(P<0.05).There was significant difference in RUSS score of fracture healing between the two groups at different time points after treatment(P<0.05);there was also significant difference in RUSS score of fracture healing between the two groups(P<0.05),but there was no interaction between the two groups and each time point(P>0.05).The Cooney scores of the two groups were significantly raised compared with those before treatment and the Cooney score of the combined treatment group was significantly higher than that of the single treatment group(P<0.05).Conclusions 3D printing technology combined with T-plate internal fixation via palmar approach has a significant effect on the treatment of distal radius fracture,and the reduction of fracture is good.It can significantly relieve the pain and limb swelling symptoms of patients,and improve the recovery of wrist joint function after operation,which is worthy of clinical application.