3D打印技术在Schazker VI型胫骨平台骨折中的临床应用

目的：探讨3D打印技术在Schazker VI型胫骨平台骨折术前规划、模拟手术和术中应用的可行性。方法：回顾性分析2017年1月至2019年10月温州市中心医院和温州医科大学附属第二医院育英儿童医院57例Schazker VI型胫骨平台骨折患者的临床资料。根据治疗方式不同，分成3D模型组和传统组。3D模型组利用3D打印模型，术前选择适合的手术方式并模拟手术；传统组行传统内固定术。2组手术后评价指标包括手术时间、术中出血量、术中C臂机透视次数，采用美国HSS表格标准评价手术侧膝关节功能。结果：3D模型组和传统组手术疗效均满意，患者都获得随访，随访时间10～16（12.8±1.9）个月。与传统组比，3D模型组手术时间（90.7±9.3）min vs. （101.3±10.9）min]，术中出血量（70.7±30.0）mL vs. （96.7± 37.4）mL]，术中透视次数（17.9±5.3）次 vs. （29.9±8.1）次]均明显减少，HSS评分（85.7±5.1）分 vs. （81.1±5.2）分]明显升高，差异均有统计学意义（P＜0.01）。结论：对比传统手术，3D打印技术在治疗Schazker VI型胫骨平台骨折具有减少手术时间、术中出血量和术中透视次数，提高HSS评分等优势。

The clinical application of three-dimensional printing technique in Schazker VI tibial plateau fracture surgery

Objective: To investigate the 3D printing technology for preoperative planning, simulation operation and operation practice of the Schazker VI tibial plateau fractures. Methods: Clinical data of fifty-seven patients with tibial plateau fractures from January 2017 to October 2019 were analyzed retrospectively. They were divided into the 3D model group and the traditional group. The operation plan for 3D model group was design according to the 3D printed models, while the traditional group underwent traditional operation. The assessment parameters included the operation time, blood loss, fluoroscopy times and HSS score. Results: The operations of both 3D model group and the traditional group were successful. All patients were followed up for 10-16 (12.8±1.9) months. In 3D model group, the operation time (90.7±9.3)min vs. (101.3±10.9)min], blood loss (70.7±30.0)mL vs. (96.7±37.4)mL], fluoroscopy times (17.9±5.3) vs. (29.9±8.1)] were all less than those in traditional group (P<0.01). But HSS score of 3D model group (85.7±5.1) vs. (81.1±5.2)] was higher than traditional group (P<0.01). Conclusion: The 3D printing technique has the advantages of less operation time, blood loss, fluoroscopy times, but higher HSS score than the traditional operation.