虚拟手术结合导板辅助7例髁突颈部骨折复位固定的效果评价

Clinical application of virtual surgery combined with guide plate in reduction and fixation of condylar neck frac-ture in 7 patients

目的:探讨数字化虚拟手术、3D打印模型结合导板在下颌骨髁突颈部骨折手术中的临床应用效果。方法:选择7例下颌髁突颈部骨折患者,行1.0 mm层厚三维CT扫描,数据通过DICOM格式导出,利用软件进行虚拟手术复位骨折,复位后3D打印出下颌骨模型。将钛板预弯曲固定,并在下颌骨模型上制作复位及钻孔导板,指导手术过程中骨折的精准复位和固定。结果:术后手术切口均无感染,创口隐蔽美观,骨折对位精确,钛板与骨折段贴合。术后随访,髁突颈部骨折愈合良好,髁突位于关节窝内。患者咬合关系良好,开口受限不明显,无开口疼痛、咬合疼痛等颞下颌关节疾病体征。结论:虚拟手术、3D打印模型结合导板能让髁突颈部骨折精确复位,简化手术过程,是一种精准、高效、可预测的手术辅助方式。

PURPOSE:To explore the value of virtual surgery and 3D printing model combined with guide plate in treat-ment of mandibular condylar neck fracture.METHODS:Seven patients with mandibular condylar neck fracture were scanned by CT for original data.The data were exported in DICOM format.A three-dimensional model was reconstructed using software,the fracture was reduced by virtual surgery,and the 3D model was printed by a 3D printer.A prebent tita-nium plate was used to fabricate the guide plate,which was used for reduction and fixation of the fracture block during surgery.RESULTS:All the postoperative incisions revealed no signs of infection,the wounds were hidden and beautiful.The implanted titanium plates were highly compatible with the reduced fracture segments.The patients were followed up for 6 months after surgery,the condylar fracture healed well and there was no obvious displacement.The patient developed no mandibular deviation with a stable occlusion,and no occlusal pain was reported.No obvious temporomandibular joint disorder was present.CONCLUSIONS:Virtual surgery and 3D printing model combined with guide plate can ensure an accurate reduction of condylar neck fracture and simplify the operation process,which can be used as an accurate,effi-cient and predictable auxiliary method.