3D打印技术辅助下尺骨远端截骨短缩术治疗尺骨撞击综合征的临床疗效

Clinical efficacy of distal ulnar osteotomy and shortening surgery assisted by 3D printing technology in the treatment of ulnar impaction syndrome

目的 探讨采用3D打印技术辅助下尺骨远端截骨治疗尺骨撞击综合征的临床疗效.方法 选取2019年5月至2022年12月于我院行尺骨远端精准截骨治疗的尺骨撞击综合征患者12例,所有患者术前均行腕关节X线片、三维CT及磁共振扫描,数据经由Minics 25.0软件转换后行3D打印,制作1:1实体骨折模型,参照3D模型精准设计尺骨远端截骨线并完善手术方案,术中根据术前设计方案进行截骨、复位及固定.采用疼痛视觉模拟评分(visual analogue scale,VAS)和改良Mayo腕关节评分对患者术前和术后末次随访的腕关节疼痛程度和功能进行评价.应用SPSS 23.0统计软件对数据进行分析.结果 术后所有患者均获得随访,时间为9~32个月,平均(23.5±9.3)个月.截骨端均获得骨性愈合,手术切口长度为(2.9±0.8)cm,愈合时间为(16.0±4.5)周,无切口相关并发症发生.术前测得尺骨变异值为(3.1±1.9)mm,术后为(-0.59±0.23)mm.术前与术后VAS分别为(6.2±1.3)和(1.4±0.5)分,改良Mayo腕关节评分分别为(49.8±14.9)和(91.2±9.4)分,差异均有统计学意义(P<0.05).结论 采用3D打印技术辅助下行尺骨远端截骨治疗尺骨撞击综合征,具有微创、精准、有效等优势,临床疗效满意.

Objective"To investigate the clinical efficacy of using 3D printing technology to assist in distal ulnar osteotomy for the treatment of ulnar impaction syndrome.Methods Twelve patients with ulnar impingement syndrome who underwent precise distal ulnar osteotomy treatment in our hospital from May 2019 to December 2022 were selected.All patients underwent wrist joint X-ray,3D CT,and magnetic resonance scanning before surgery.The data was converted by Minics 25.0 software and a 1:1 solid fracture model was made by 3D printing.The distal ulnar osteotomy line was accurately designed based on the 3D model and the surgical plan was improved.During surgery,osteotomy,reduction,and fixation were performed according to the preoperative design plan.The visual analogue scale(VAS)and modified Mayo wrist joint score were used to evaluate the degree and function of wrist joint pain in patients during preoperative and postoperative follow-up.SPSS 23.0 statistical software was used to analyze the data.Results All postoperative patients were follow-up for a period of 9 to 32 months,with an average of(23.5±9.3)months.All osteotomy ends achieved bone healing,with a surgical incision length of(2.9±0.8)cm and a healing time of(16.0±4.5)weeks.No incision related complications occurred.The variation value of the ulna bone measured before surgery was(3.1±1.9)mm,and after surgery it was(-0.59±0.23)mm.The preoperative and postoperative VAS were(6.2±1.3)and(1.4±0.5)points,respectively,and the modified Mayo wrist joint score was(49.8±14.9)and(91.2±9.4)points,with statistically significant differences(P<0.05).Conclusion The use of 3D printing technology to assist in distal ulnar osteotomy for the treatment of ulnar impaction syndrome has advantages such as minimally invasive surgery,accuracy,and effective treatment,with satisfactory clinical efficacy.