3D打印技术辅助钢板内固定治疗SchatzkerⅠ~Ⅵ型胫骨平台骨折研究

Study of 3D print technology-assisted plate internal fixation in treating Schatzker typeⅠ-Ⅵtibial plateau fractures

目的探究3D打印技术辅助下钢板内固定术治疗SchatzkerⅠ~Ⅵ型胫骨平台骨折的应用价值。方法我院急诊创伤外科2020年1月~2022年10月收治的SchatzkerⅠ~Ⅵ型胫骨平台骨折病人86例,按治疗方式分为观察组与对照组,其中接受3D打印技术辅助下钢板内固定术治疗的病人为观察组,接受传统钢板内固定术治疗的病人为对照组。采用倾向性匹配评分法排除性别、年龄等基线资料混杂因素(卡钳值为0.02),最终两组各获得43例。对比两组手术用时、术中出血量、术中透视次数、骨折复位优良率、骨折的骨性愈合时间、膝关节功能评分。结果观察组手术所用时间、透视次数、出血量均低于对照组,差异均有统计学意义(P<0.05)。观察组骨折愈合时间为(12.56±1.49)周,短于对照组的(16.53±1.83)周,差异有统计学意义(P<0.05)。术后6个月时,观察组的Rasmussen放射学评分为(16.86±1.04)分,高于对照组的(15.07±1.55)分,复位效果分级优于对照组,差异有统计学意义(P<0.05);观察组的膝关节Rasmussen临床评分为(26.63±1.56)分,高于对照组的(25.67±2.21)分,差异有统计学意义(P<0.05)。结论在3D打印技术辅助钢板内固定术治疗SchatzkerⅠ~Ⅵ型胫骨平台骨折价值显著,能缩短手术时间,减少手术创伤,减少术中透视次数,可提供骨折复位效果,明显恢复膝关节功能。

Objective To explore the application value of 3D print technology-assisted plate internal fixation in the treatment of Schatzker typeⅠ-Ⅵtibial plateau fractures.Methods Patients with Schatzker typeⅠ-Ⅵtibial plateau fractures admitted to department of emergency trauma surgery of Jining First People's Hospital were retrospectively analyzed from January 2020 to October 2022,and they were classified into the observation group and the control group by different treatment methods.The patients who received 3D print technology-assisted plate internal fixation were assigned as the observation group,and the patients who underwent traditional plate internal fixation were enrolled as the control group.The confounding factors of baseline data such as gender and age were excluded by propensity matching score(caliper=0.02),and 43 cases were finally obtained in each group.The surgical time,intraoperative blood loss,intraoperative fluoroscopy frequency,excellent and good rate of fracture reduction,bone healing time of fracture and knee function score were compared.Results The surgical time,fluoroscopy frequency and blood loss in the observation group were shorter or lower than those in the control group(P<0.05).The fracture healing time in the observation group was(12.56±1.49)weeks,which was shorter than(16.53±1.83)weeks in the control group(P<0.05).At 6 months after surgery,the Rasmussen radiology score in the observation group with(16.86±1.04)points,which was higher than(15.07±1.55)points in the control group,and the reduction effect grading was better than that in the control group(P<0.05).The knee Rasmussen clinical score in the observation group was(26.63±1.56)points,which was higher than(25.67±2.21)points in the control group(P<0.05).Conclusion 3D print technology-assisted plate internal fixation has significant value in treating Schatzker typeⅠ-Ⅵtibial plateau fractures,and can shorten the surgical time,reduce the surgical trauma,lower the intraoperative fluoroscopy frequency,enhance the fracture reduction effect and significantly restore the knee function.