3D打印技术在胫骨平台粉碎性骨折手术治疗中的应用

Application of three-dimensional printing technique in surgical treatment of comminuted fracture of tibial plateau

目的 探讨3D打印技术在手术治疗胫骨平台粉碎性骨折中的应用效果。方法 将20例胫骨平台粉碎性骨折患者根据术前是否采用3D打印技术分为观察组(采用3D打印技术辅助内固定治疗,10例)和对照组(采用常规内固定治疗,10例)。比较两组手术情况、骨折愈合情况、膝关节KSS评分以及活动度。结果 患者均获得6个月随访。手术时间、术中出血量、术中透视次数观察组均短(少)于对照组(P<0.05)。开始部分负重时间、骨痂开始形成时间、骨折愈合时间两组比较差异均无统计学意义(P>0.05)。术后1、3、6个月膝关节KSS评分以及术后6个月KSS评分优良率两组比较差异均无统计学意义(P>0.05)。末次随访时,膝关节屈曲度观察组大于对照组(P<0.05)。结论 3D打印技术应用于胫骨平台粉碎性骨折的手术治疗中可起到缩短手术时间、减小手术创伤、减少医患放射线曝露的作用。

Objective To investigate the effect of three-dimensional(3D)printing technique in the surgical treatment of comminuted fracture of tibial plateau.Methods Twenty patients with comminuted fracture of tibial plateau were divided into observation group(10 cases were treated with 3D printing technique assisted internal fixation)and control group(10 cases were treated with conventional internal fixation),according to whether 3D printing technique was used before operation.The operation conditions,fracture healing,KSS score and range of motion of the knee joint were compared between the two groups.Results All patients were followed up for 6 months.The operation time,intraoperative blood loss and intraoperative fluoroscopy times in the observation group were shorter(less)than those in the control group(P<0.05).There were no significant differences in the time to start partial weight-bearing,time to start callus formation,and fracture healing time between the two groups(P>0.05).The KSS score of knee joint at 1,3,6 months postoperation and the excellent-good rate of KSS score at postoperative 6 months had no statistical differences between two groups(P>0.05).At last follow-up,knee flexion in the observation group was larger than that in the control group(P<0.05).Conclusions 3D printing technique can shorten operation time,reduce surgical trauma and reduce radiological exposure in the treatment of patients with comminuted tibial plateau fracture.