3D打印技术在肱骨近端粉碎性骨折中的临床应用研究

Clinical application of 3D printing technology in comminuted fractures of proximal humerus

目的探讨3D打印技术应用于肱骨近端粉碎性骨折中的临床价值。方法36例肱骨近端粉碎性骨折患者,依据治疗方法不同分为观察组(16例)与对照组(20例)。对照组采用切开复位锁定钢板内固定术治疗,观察组采用3D打印技术辅助钢板内固定治疗。比较两组围术期指标、术后3个月的Neer肩关节功能评分、临床疗效及并发症发生情况。结果观察组术中出血量(140.62±20.50)ml、C臂透视次数(2.80±1.02)次少于对照组的(183.44±23.75)ml、(5.54±1.22)次,手术时间(98.45±9.55)min短于对照组的(120.40±11.65)min,术后3个月Neer肩关节功能评分(78.46±5.44)分高于对照组的(70.14±8.24)分,差异均有统计学意义(P<0.05)。观察组并发症发生率6.25%低于对照组的40.00%,差异有统计学意义(P<0.05)。结论3D打印技术应用于肱骨近端粉碎性骨折内固定中可减少术中出血、术中透视次数及并发症发生率,提高手术疗效、术后肩关节功能,其应用效果理想。

Objective To discuss the clinical value of 3D printing technology in comminuted fractures of proximal humerus.Methods A total of 36 patients with comminuted fracture of proximal humerus were divided into observation group(16 cases)and control group(20 cases)according to different treatment methods.The control group was treated with open reduction and locking plate internal fixation,and the observation group was treated with plate internal fixation assisted by 3D printing technology.The perioperative indicators,the Neer shoulder joint function score at 3 months after surgery,clinical efficacy,and the incidence of complications were compared between the two groups.Results The intraoperative blood loss(140.62±20.50)ml,and number of C-arm fluoroscopy(2.80±1.02)times in the observation group were less than(183.44±23.75)ml,and(5.54±1.22)times in the control group;the operation time(98.45±9.55)min in the observation group was shorter than(120.40±11.65)min;the Neer shoulder joint function score(78.46±5.44)points in the observation group was higher than(70.14±8.24)points in the control group at 3 months after surgery;all the differences were statistically significant(P<0.05).The incidence of complications 6.25%in the observation group was lower than 40.00%in the control group,and the difference was statistically significant(P<0.05).Conclusion The application of 3D printing technology has ideal effect in internal fixation of comminuted fractures of proximal humerus,and can reduce intraoperative blood loss,number of intraoperative fluoroscopy and incidence of complications,improve surgical efficiency and postoperative shoulder function.