摘要
目的探讨快速成型（RP）技术对肱骨近端复杂骨折的诊断及治疗的辅助作用。方法回顾性分析2010年1月至2014年1月收治的18例肱骨近端粉碎性骨折患者资料，男7例，女11例；年龄39～78岁，平均62岁。所有患者均为闭合性新鲜骨折，其中10例患者经三维CT扫描并采用RP制备骨折模型，然后通过模型确定骨折分型（骨折Neer分型：三部分骨折7例，四部分骨折3例），指导手术治疗（3D技术组）；8例患者常规行切开复位内固定术治疗（常规组）（骨折Neer分型：三部分骨折6例，四部分骨折2例）。比较两组患者的手术时间、术中出血量等。术后6个月采用Neer评价标准评定疗效。结果通过对1：1等大的RP模型分析研究，明确骨折类型后均顺利完成术前制定的手术方案。3D技术组患者的手术时间（平均1．1h）及术中出血量（平均190mL）均少于常规组患者（1．5h、240mL）。所有患者术后获7～23个月（平均16个月）随访。骨折愈合时间3～5个月（平均4．3个月）。术后6个月采用Neer评价标准评定疗效：3D技术组：优5例，良4例，可1例；常规组：优3例，良4例，可1例。结论1：1的RP模型能直观、准确地展现骨折伤情，使手术方案具体化、个体化，可减少术中出血量并缩短手术时间，提高疗效。
Objective To explore the auxiliary role of rapid prototyping （RP） technique in diagnosis and operation design for complex fractures of proximal humerus. Methods A retrospective study was conducted to analyze the 18 patients with complex fracture of proximal humerus who had been treated by authors from January 2010 to January 2014. They were 7 men and 11 women, aged from 39 to 78 years （average, 62 years）. All fractures were fresh and closed. Ten patients underwent three-dimensional CT scan and RP was used to prepare their fracture models which were used to guide their operation design （3D group）. By Neer classification, 7 of them had three-part fractures and 3 four-part fractures. Another 8 patients received conventional open reduction and internal fixation （control group）. By Neer classification, 6 of them had three-part fractures and 2 four-part fractures. The 2 groups were compared in terms of operation time and intraoperative bleeding. Their outcomes were assessed using Neer evaluation criteria 6 months postoperation. Results The RP fracture models of 1 ： 1 ratio facilitated classification of the fractures and the fallowing operation design. The 3D group incurred less operation time （1. 1 hours on average） and bleeding （190 mL on average） than the control group （1.5 hours and 240 mL）. All the patients were followed up for 7 to 23 months （16 months on average）. Fractures healed after 3 to 5 months （4. 3 months on average）. Neer evaluation 6 months postoperation showed 5 excellent cases, 4 good cases and one fair case in the 3D group while 3 excellent cases, 4 good cases and one fair case in the control group. Conclusions The fracture models of 1：1 ratio man- ufactured by RP technique may help surgeons to gain accurate and visualized knowledge of the fracture to be treated. Consequently their surgical plan can be more specific and more individualized with the aid of RP models. Therefore, operation time and bleeding can be reduced to improve the curative effect.
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2015年第1期55-58,共4页
Chinese Journal of Orthopaedic Trauma
关键词
肩关节
早期诊断
计算机模拟
快速成型
Shoulder joint
Early diagnosis
Computer simulation
Rapid prototyping
作者简介
通信作者：刘建，E—mail：liren@fmmu．edu．cn
