3D打印技术辅助克氏针内固定术治疗儿童肱骨髁上骨折

3D printing technology-assisted Kirschner wire internal fixation for the treatment of pediatric supracondylar humeral fracture

目的:探讨3D打印技术辅助克氏针内固定术治疗儿童肱骨髁上骨折的临床效果。方法:选取2019年11月至2020年4月采用克氏针内固定术治疗的肱骨髁上骨折患儿79例作为常规治疗组,2020年5月至2020年11月采用3D打印技术辅助克氏针内固定术治疗肱骨髁上骨折患儿77例作为3D打印组。比较两组患者的手术指标、疗效指标及预后情况。结果:3D打印组患者的手术时间、术中透视次数、术中透视时间均少于常规治疗组(P<0.05);术后7 d的疼痛视觉模拟评分(VAS)低于常规治疗组(P<0.05);固定物取出时间、术后恢复训练开始时间均早于常规治疗组(P<0.05)。两组患者术后14 d、1个月的VAS评分比较,差异均无统计学意义(P>0.05)。两组患者术后1、3、6个月的Mayo肘关节功能评分优良率比较,差异无统计学意义(P>0.05)。3D打印组发生针道感染1例,常规治疗组发生针道感染3例,经治疗后均好转,随访期间未发生Volkman挛缩、肘内翻畸形等其他并发症,两组患者的并发症发生率、骨折愈合时间比较,差异均无统计学意义(P>0.05)。结论:采用3D打印技术辅助克氏针内固定术治疗儿童肱骨髁上骨折,有利于缩短手术时间,促进术后早期恢复,并发症较少,肘关节功能恢复满意。

Objective:To investigate the prognosis of 3D printing technology-assisted Kirschner wire internal fixation for the treatment of supracondylar humeral fractures in children.Methods:A total of 79 children with supracondylar humeral fractures underwent Kirschner wire internal fixation from November 2019 to April 2020,were enrolled as the routine group,while 77 children with supracondylar humeral fractures underwent 3D printing technology-assisted Kirschner wire internal fixation from May 2020 to November 2020,were enrolled as the combined group.Surgical indicators,treatment efficacy,and prognosis were compared between the two groups.Results:In the combined group,the operation time,intraoperative fluoroscopy frequency,and overall fluoroscopy time were all shorter or fewer than those in the routine group(P<0.05).The visual analogue scale(VAS)score at 7 days post-operation,fixation removal time,and the start time of postoperative recovery training in the combined group were significantly lower than those in the routine group(P<0.05).There was no significant difference in VAS score between the two groups at 14 days or 1 month postoperation(P>0.05).There was no significant difference in the excellent or good rate of elbow function(Mayo score)between the two groups at 1 month,3 months,or 6 months post-operation(P>0.05).Needle tract infection occurred in one case in the combined group and three cases in the conventional group.All the patients improved after treatment.No other complications such as Volkman contracture and cubitus varus deformity occurred during the follow-up.There was no significant difference in the incidence of complications and fracture healing time between the two groups(P>0.05).Conclusions:The use of 3D printing technology-assisted Kirschner wire internal fixation for the treatment of pediatric supracondylar humeral fractures is advantageous for reducing operation time,promoting early postoperative recovery,minimizing complications,and achieving satisfactory recovery of elbow function.