3D打印体外导板辅助儿童膝内外翻畸形矫正的初步应用

目的 利用3D打印技术研制个体化膝部体外导板,探讨其应用于8字钢板骨骺阻滞术的可行性.方法 对2014年1月至2016年1月该院诊治的12例膝内外翻患儿(男7例,女5例;平均年龄8.2岁,膝关节伸直位时完成下肢连续螺旋CT扫描,将Dicom格式存储的CT数据导入Mimics 15.0中,重建膝关节三维模型.将重建后的膝关节数据以.stl格式导入Geomagic 11.0软件中,根据置钉不穿破骨骺和关节面、与骨骺平行、位于骨骺前后中线的要求,设计出8字钢板置钉导航模板;利用3D打印技术打印出导航模板;术中通过模板定位,行8字钢板及螺钉内固定,术后CT评估置钉位置.结果 经过影像学验证,应用3D打印个体化体外导板对12例患者行8字钢板骨骺阻滞术,置钉准确.病例随访6个月至2年,均取得满意矫形效果.结论 3D打印制作个体化膝部体外导板,辅助8字钢板骨骺阻滞治疗儿童膝内外翻畸形,置钉位置精准,疗效满意.

Preliminary application of 3D printing in vitro guide plate assisted deformity correction in child genu varus or valgum

Objective To research and prepare the individualized knee in vitro guided plate by 3D printing technique and to investigate the feasibility of its application in 8-plate epiphysiodesis.Methods Twelve children patients with knee varus or valgum in our hospital from January 2014 and November 2016,7 boys and 5 girls,average age of 8.2 years old,were performed the lower extremity continuous spiral CT scanning in the knee straight position.The Dicom format stored CT data were imported into software Mimics 15.0 for reconstructing the knee joint 3D model.The knee joint data after reconstruction were guided into software Geomagic1 1.0 with the.stl format.According to the demand that screws without perforating epiphyseal and joint surface,paralle ling to the epiphyseal and locating in the anterior-posterior median line of epiphyseal,the 8-plate placing screw navigation template was designed and printed by using the 3D printing technique;the 8-plate plate and screw internal fixation was conducted by intraoperative template location.The placed screw position was evaluated by postoperative CT.Results The imaging identification showed that 8-plate epiphysiodesis by using 3D printing individualized in vitro guided plate had accurate screw placement.The cases were followed from 6 months to 2 years,the satisfactory orthopedic effect was obtained in all cases.Conclusion Preparing the individualized knee in vitro guided plate by applying 3D printing technique in assisted 8-plate epiphysiodesis for treating child knee varus or valgum has accurate screw position and satisfactory effect.