基于3D打印技术的数字化设计在胫骨远端粉碎性骨折内固定手术中的疗效及安全性分析

Analysis of efficacy and safety of digital design based on 3D printing technology in internal fixation of distal tibial comminuted fracture

目的:探究基于3D打印技术的数字化设计在胫骨远端粉碎性骨折内固定手术中的疗效及安全性。方法:选择2019年2月—2022年2月于徐州市肿瘤医院收治的148例单侧胫骨远端粉碎性骨折患者;采用随机数字表法均分为观察组(数字化设计结合3D打印技术辅助手术)和对照组(传统切开复位内固定术),每组74例。比较两组患者的临床疗效,采用随机行走模型评价两种手术方法的疗效和安全性。结果:与对照组相比,观察组的疗效优良率、术后6个月美国矫形外科足踝协会(AOFAS)评分和Barthel指数均更高(P<0.05),手术时间及骨折愈合时间均更短(P<0.05),术中出血量更少(P<0.05),术后6个月疼痛视觉模拟评分(VAS)、术后24 h肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和IL-8水平均更低(P<0.05)。随机行走模型评价结果显示,观察组患者治疗后手术指标、术后关节功能、疼痛、生活质量及炎症反应的改善情况均更优于对照组。两组术后6个月并发症发生率差异无统计学意义(P>0.05)。结论:基于3D打印技术的数字化设计的内固定手术可有效改善胫骨远端粉碎性骨折患者的手术指标、术后关节功能、疼痛、生活质量及炎症反应,且临床治疗优良率较高,并发症发生率较低。

Objective To explore the efficacy and safety of digital design based on 3D printing technology in internal fixation of distal tibial comminuted fracture.Methods 148 patients with unilateral comminuted fracture of distal tibia who received surgical treatment in Xuzhou Cancer Hospital from February 2019 to February 2022 were selected as the study subjects.Randomized numerical table method was used to divide the patients into observation group(74 cases)and control group(74 cases).The clinical data of the two groups were analyzed.Randomized walking model was used to evaluate the improvement of clinical indicators of patients with two surgical treatment methods.Results Compared with the control group,the clinical treatment excellent rate,American Orthopedic Foot and Ankle Association(AOFAS)score and Barthel index of patients in the observation group were higher 6 months after operation(P<0.05),the operation time and fracture healing time were shorter(P<0.05),the intraoperative bleeding was less(P<0.05),and the visual analog score of pain(VAS)of patients in 6 months after operation,tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)and IL-8 water in 24 hours after operation were lower(P<0.05).The evaluation results of random walking model showed that the improvement of surgical indicators,postoperative joint function,pain,quality of life and inflammatory reaction in the observation group were better than those in the control group.The rate of complications in the observation group at 6 months after operation were no significant differences between the two groups(P>0.05).Conclusion The digitally designed internal fixation operation baseds on 3D printing technology can effectively improve the surgical indicators,postoperative joint function,pain,quality of life and inflammatory reaction of comminuted fracture of distal tibia patients.The clinical treatment rate is high,while the rate of complications is low.