3D打印应用于髋臼骨折数字化设计的实验研究

目的　探讨髋臼骨折数字化设计及实施的可行性方案并以3D打印技术进行验证。  方法    采集52例临床髋臼骨折薄层CT扫描数据，在Mimics14.0中进行三维建模和虚拟骨折复位并在复位模型上优化预设植入钢板位置和虚拟钉道模拟、测量钉道长度，三维切割预设植入钢板部位骨块并3D打印，据此进行钢板折弯。将所有骨折块进行3D打印为实体模型结合折弯钢板进行内固定植入模拟。将钢板现实位置、螺钉方向和长度同数字化设计比较。  结果    总植入61根重建钢板，螺钉424颗，钢板植入位置和螺钉植入方向均与数字化设计高度吻合，钉道长度与数字化设计进行配对t检验，P=0.325。  结论    （1）数字化设计结合3D打印技术能在术前完成重建钢板折弯并进行手术模拟，折弯钢板模拟植入位置、螺钉植入方向、长度和虚拟设计高度一致。（2）术前折弯重建钢板对骨折复位有一定的指导价值。

The application of 3D printing technique in the research of acetabular fractures

Objective    To evaluate the digital design of acetabular fractures and the feasibility of the implementation, then using the 3D printing technique to verify the results.    Methods    Fifty-two patients with acetabular fractures were enrolled in this study. Data of lamellar CT scanning were imported into Mimics14.0 software for 3D anatomical modeling and virtual fracture reduction. Then the default embedded steel plate location was optimized , the screw path evaluated，and the screw length measured. 3D printing technique was used to print the bone. Plates were bended based on the printing bones. Internal fixation implants were simulated based on all the printed bones and bended plates. Finally, the real operation was compared with virtual preoperative design in terms of the fixation position of plates, the direction and the length of screws. Results    In the study, 61 plates and 424 screws were planted. The position of plates and the direction of screws were in high accordance with the digital design. The length of screws are compared with Paired-samples t Test and P=0.325.   Conclusion    Firstly, the combination of the digital design and 3D printing technique have a good application in the bending of the plates and surgery simulation before operation. The real operation is quite consistent with the simulated results. Secondly, plate bending before the real operation has a certain value in the guidance of fracture reduction.