3D打印技术在髋臼双柱骨折手术治疗中的辅助作用

目的探讨3D打印技术在髋臼双柱骨折手术治疗中的辅助作用。方法回顾性分析2012年1月至2018年11月本院创伤骨科治疗并获得随访的19例髋臼双柱骨折患者,在术前采用3D打印技术制作骨盆髋臼模型并在该模型上完成预手术、钢板塑形、术前规划,最终实施切开复位内固定手术。所有患者术前均采集骨盆髋臼CT数据,进行三维重建,将数据输入3D打印计算机软件,采用3D打印技术打印骨盆模型,进行术前规划及模拟手术。统计患者的手术时间、术中出血量、术后骨折复位情况及髋关节功能评分。末次随访根据改良的Merle d’Aubigne和Postel评分标准评定临床结果。结果本组19例髋臼双柱骨折患者均获得良好的骨折复位。手术时间为1.5~3.6 h,平均2 h;术中出血量为220~1 300 mL,平均523 m L;骨折愈合时间为9~16周,平均13.2周。末次随访根据改良的Merle d’Aubigne和Postel评分标准:优10例,良7例,可1例,差1例,优良率89.5%。结论利用3D打印技术,在术前能为髋臼双柱骨折患者制定精准的手术方案,缩短手术时间,缩短创伤骨科医师的学习曲线,临床效果良好。

Effects of 3D printing technology guided double-column acetabular fracture surgery

Objective To evaluate the clinical effect of 3D printing technology for double-column acetabular fracture surgery. Methods From January 2012 to November 2018, 19 patients with double-column acetabular fractures were recruited and examined by CT scan at our hospital. The 3D printing acetabulum model was constructed according to surgery simulation and steel plate prebending. The operation time, intraoperative bleeding volume and the outcomes of acetabular fracture repair were observed. At the latest follow-up, using the Merle d''Aubigne-Postel criteria, the hip functions to access the clinical effects. Results Excellent reduction was obtained in all cases. The average operation time was 2 h(range, 1.5-3.6 h). The average operative blood loss was 523 mL (range, 220-1 300 mL). The average healing time was 13.2 weeks (range, 9-16 weeks). At the latest follow-up, according to the Merle d''Aubigne-Postel criteria, the hip functions were excellent in 10 cases, good in 7 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 89.5% (17/19). Conclusion The 3D printing technology for double-column acetabular fractures is feasible, accurate and effective leading to precise individual preoperative planning and improved outcome of real surgery.