摘要
目的探讨3D打印结合微创钢板内固定技术治疗胫骨远端骨折的临床疗效。方法选取2017年1月—2017年10月于武汉科技大学附属普仁医院骨科确诊的闭合性胫骨远端骨折患者24例,按照随机数字表法将其分为3D微创组和常规微创组;患者均行胫腓骨下段CT扫描。3D微创组数据以医学数字成像及通信格式输出,数据经Mimics软件处理后输入3D打印机,制作出与骨折部位比例1∶1的骨折模型,术前模拟复位,制定个性化手术方案;常规微创组按常规MIPPO技术行骨折内固定术。比较两组患者手术时间、术中出血量、术中透视次数;采用Burwell-Charnley标准评价骨折复位情况;采用AOFAS踝关节评分系统评价患者术后12个月踝关节功能恢复情况。结果两组Burwell-Charnley影像学评价比较,差异无统计学意义(P>0.05);3D微创组手术时间、术中出血量和术中透视次数少于常规微创组(P<0.05);两组术后踝关节AOFAS评分比较,差异无统计学意义(P>0.05)。结论应用3D打印结合微创钢板内固定技术治疗胫骨远端骨折较传统微创手术具有明显优势,可以为胫骨远端骨折治疗提供新的思路。
Objective To investigate the clinical effect of 3D printing combined with minimally invasive plate in the treatment of distal tibial fractures.Objective From January 2017 to October 2017,24 patients with closed distal tibial fractures were diagnosed in the Department of Orthopaedics,Puren Hospital affiliated to Wuhan University of Science and Technology.They were randomly divided into 3D minimally invasive group(n=12)and conventional minimally invasive group(n=12)according to the number table method,and all patients underwent CT scan of the lower tibia and fibula.The data of 3D minimally invasive group were output in medical digital imaging and communication(Digital Imaging and Communications in Medicine,DICOM)format.The data were processed by software and input into 3D printer to make a fracture model with a ratio of 1:1 to fracture site and simulated reduction before operation.According to the routine MIPPO technique,the fracture internal fixation was performed in the conventional minimally invasive group.The operation time,intraoperative blood loss and intraoperative fluoroscopy were compared between the two groups;Burwell-Charnley standard was used to evaluate the reduction of fracture;AOFAS ankle score system was used to evaluate the functional recovery of ankle joint 12 months after operation.Results There was no significant difference in imaging scores between the two groups(P>0.05);the operation time,blood loss and the number of fluoroscopy in 3D minimally invasive group were significantly better than those in conventional minimally invasive group(P<0.05);the AOFAS ankle score of 3D minimally invasive group was compared with that of conventional minimally invasive group at 12 months after operation.There was no significant difference(P>0.05).Conclusion The application of 3D printing combined with minimally invasive plate technique in the treatment of distal tibial fractures has obvious advantages over traditional minimally invasive surgery,and can provide a new idea for the treatment of distal tibial fractures.
作者
张明
徐俊华
丁凡
刘融
陈令斌
张奕
Ming Zhang;Jun-hua Xu;Fan Ding;Rong Liu;Ling-bin Chen;Yi Zhang(Department of Orthopedics Surgery,Puren Hospital,Wuhan University of Science and Technology,Wuhan,Hebei 430081,China)
出处
《中国现代医学杂志》
CAS
2019年第22期48-52,共5页
China Journal of Modern Medicine
基金
湖北省卫生计生委科研基金（No:WJ2018H0093）
武汉市卫生计生委科研基金（No:WX17Q32）
关键词
成像
三维
外科手术
微创性
胫骨骨折
printing,three-dimensional
minimally invasive surgical procedures
tibial fracture
作者简介
通信作者:张奕,E-mail:ethanizhang@163.com,Tel:18571525144。
