3D打印个体化模型辅助治疗复杂踝关节骨折的效果分析

Analysis on effects of 3D printed individualized model in assisted treatment of complex ankle fractures

目的探讨复杂踝关节骨折应用3D打印个体化模型联合微创复位固定术的治疗效果。方法回顾性分析2017年6月至2019年6月该院收治的65例复杂踝关节骨折患者的临床资料,根据治疗方式的不同分为对照组(微创复位固定术治疗,n=29)和观察组(3D打印个体化模型联合微创复位固定术治疗,n=36)。比较两组患者围术期相关指标、复位效果,术后1、3、6、12个月两组患者踝关节功能,骨折愈合时间及并发症发生情况,以及两组患者治疗费用。结果观察组患者手术时间、住院时间、开始活动时间短于对照组,术中失血量少于对照组,差异均有统计学意义(P<0.01);观察组患者解剖复位构成比及术后1、3、6、12个月踝关节功能评分高于对照组,差异均有统计学意义(P<0.05);观察组患者骨折愈合时间短于对照组,随访期间并发症总发生率低于对照组,差异均有统计学意义(P<0.05);但观察组患者治疗费用高于对照组,差异有统计学意义(P<0.05)。结论3D打印个体化模型联合微创复位固定术可改善复杂踝关节骨折患者围术期指标及复位效果,但费用较高。

Objective To study the therapeutic effect of 3D printed individualized model combined with minimally invasive reduction and fixation of complex ankle joint fractures.Methods The clinical data of 65 patients with complex ankle fractures treated in this hospital from June 2017 to June 2019 were retrospectively analyzed,and they were divided into the control group(minimally invasive reduction and fixation treatment,n=29)and observation group(3D printing individualized model combined with minimally invasive reduction and fixation,n=36)according to different treatment methods.The related indexes during the perioperative period,reduction effect,ankle joint function in postoperative 1,3,6,12 months,fracture healing time,complications occurrence and treatment costs were compared between the two groups.Results The operation time,hospitalization time and time of starting to move in the observation group were shorter than those in the control group,the blood loss amount during the operation was less than that of the control group,and the differences were statistically significant(P<0.01).The composition ratio of anatomical reduction and the ankle function scores at postoperative 1,3,6,12 months in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The fracture healing time in the observation group was shorter than that in the control group,the total incidence rate of complications during follow up period was lower than that in the control group,and the differences were statistically significant(P<0.05).But the treatment cost in the observation group was higher than that in the control group with statistical difference(P<0.05).Conclusion The 3D printing individualized model combined with minimally invasive reduction and fixation can improve the perioperative indexes and reduction effect of the patients with complex ankle fractures,but the cost is high.