计算机辅助测量联合3D打印技术在Taylor空间支架治疗小腿畸形中的应用

目的 探讨运用计算机辅助测量联合3D打印技术在Taylor空间支架治疗小腿畸形中的可行性及临床效果。方法 回顾性分析2016年5月至2018年10月在福建中医药大学附属厦门第三医院运用Taylor空间支架治疗小腿畸形的6例病人的临床资料。通过CT薄层扫描，3D打印技术制作骨模型和截骨导板。根据Taylor空间支架配套软件所需参数应用Mimics软件进行测量，按照配套软件的规划在3D打印模型验证矫形结果。术后参照 Johner-Wruhs评定标准进行患肢功能评价。结果 6例病人均获得随访，随访时间为9~25个月，平均15.2个月。其中1例钉道感染，未发生神经、血管损伤和骨不连。拆除外固定时间为12~16周，平均13.7周。术后患肢无跛行。末次随访按照Johner-Wruhs评定标准，优5例，良1例。结论 计算机辅助测量联合3D打印技术在Taylor空间支架治疗小腿畸形中可获得良好的临床疗效，并具有测量准确，截骨精确，矫形精准，调整方便等优势，是小腿复杂畸形精准化矫形的有效治疗方法。

Application of Taylor spatial frame with computer assisted measurement combined with 3D printing in the treatment of tibial deformity

Objective To evaluate effectiveness and outcomes of computer assisted measurement combined with 3D printing of Taylor spatial frame for treatment of tibial deformity. Methods From May 2016 to October 2018, 6 patients with tibial deformity were treated with Taylor spatial frame in Xiamen Third Hospital, Fujian University of Traditional Chinese Medicine. The 3D modeling and custom-made surgical guide were printed based on a three-dimensional computer tomography. The software of Taylor spatial frame was established according to the data obtained from Mimics software, and postoperative rehearsal was performed on 3D printed models for checking the result of deformity correction. The function of the affected limb was evaluated by Johner-Wruhs standard after operation. Results Six patients were followed up for an average of 15.2 months (from 9 to 25 months). All patients obtained the fracture healing without neurovascular injury. There was 1 case of pin infection. The stent removal time was 12-16 weeks (mean, 13.7 weeks). According to the Johner-Wruhs standard, the results were excellent in 5 cases, and good in 1 case. Conclusion Computer assisted measurement and 3D printing of Taylor spatial frame for treatment of tibial deformity can provide accurate cutting, measurement and deformity correction, which is relatively effective and precise.