摘要
目的设计骨盆环损伤3D打印钛板塑形模板并探讨其在骨盆环损伤的应用。方法回顾性分析2016年5月至2018年6月间佛山市三水区人民医院创伤骨科12例使用了3D打印塑形模板辅助骨盆环损伤手术的患者资料。术前通过软件对患者术前CT图像进行数字重建、处理得到实体骨盆模型、空心骨盆模型(壁厚1.2mm)。通过骨折模拟复位等方法获取完好的实体数字骨盆后设计钛板塑形模板,并通过光固化成型制造模板,记录模板设计到最终制造成型的总时间以及耗材,并与实体骨盆模型、空心骨盆模型在制作时间、消耗耗材进行比较。在术前钛板植入前使用模板辅助钛板塑形,记录术前钛板塑形时间,术中记录骨折复位后到开始安装钛板记为术中钛板准备时间,两者进行比较。通过重建术后骨盆模型并与术前修复骨盆的比较了解整个技术流程的准确性。术后采用Matta评分评定骨盆复位质量。术后6个月采用Majeed评分评定疗效。结果所有患者术后获6~28个月(平均16.3个月)随访。塑形模板设计制造总时间以及耗材消耗比打印实体或空心骨盆少,差异有统计学意义(P<0.05)。术前钛板塑形时间(12.8±4.1)min,术中钛板准备时间(1.4±1.0)min,差异有统计学意义(P<0.05)。术后骨盆模型与术前修复骨盆模型比对的"平均误差"为(1.4±1.1)mm。术后Matta评分:优6例,良4例,可2例;术后6个月Majeed评分:优7例,良4例,可1例。结论使用3D打印内固定塑形模板应用于骨盆骨折具备成本优势,能减少术中钛板准备时间,且手术复位满意,符合术前规划预期,具备可行性。
Objective To explore the application of 3D printing templates for titanium plate contouring (TTPC) in pelvic ring surgery. Methods From May 2016 to June 2018,12 patients with pelvic ring injury were treated by internal fixation with 24 titanium plates at Department of Orthopedics and Trauma,Sanshui People's Hospital.After solid digital models of the damaged pelves of the patients were reconstructed from their CT images via software,the hollowed ones were created with the wall thickness of 1.2 mm.After the models of damaged pelves were restored to be intact,the templates for titanium plate contouring were designed based on the area of fixation and manufactured via a stereo lithography apparatus.The total manufacturing time and material consumption of 3D printing TTPC were recorded and compared with those of 3D printing solid and hollow models.Before operation,the titanium plates were contoured according to the templates.The time for preoperative shaping the plate and the time for intraoperative preparing the plate before installation were recorded.After operation,all patients underwent CT scan again for reconstruction of 3D models of the post-operative pelves which were compared with their corresponding preoperative ones in the software.Matta criteria were used to evaluate the pelvic reduction and Majeed criteria to evaluate the functional recovery 6 months after operation. Results All patients were followed up for 6 to 28 months (average,16.3 months).The total manufacturing time and material consumption of 3D printing a TTPC were significantly less than those of 3D printing a solid or hollow model (P<0.05).The time for preoperative shaping the plate was 12.8±4.1 minutes and the time for intraoperative preparing the plate was 1.4±1.1 minutes.The average deviation between the preoperative 3D models and the postoperative ones was 1.4±1.1 mm.According to the Matta criteria for pelvic reduction,6 cases were excellent,4 good and 2 satisfactory.According to the Majeed criteria,the pelvic functions were excellent in 7
作者
张帆
何志明
吴天秀
刘子卿
汪志中
李新旭
潘磊
Zhang Fan;He Zhiming;Wu Tianxiu;Liu Ziqing;Wang Zhizhong;Li Xinxu;Pan Lei(Department of Orthopedics and Trauma,Sanshui People's Hospital,Foshan 528100,Guangdong,China;Department of Human Anatomy,Guangdong Medical University,Guangzhou 524023,China;Department of Spine and Joint,Sanshui People's Hospital Foshan 528100,China)
出处
《中华创伤骨科杂志》
CAS
CSCD
北大核心
2019年第2期153-159,共7页
Chinese Journal of Orthopaedic Trauma
基金
广东省医学科研基金项目.
关键词
骨盆
骨折固定术
内
钛板塑形模板
3D打印
Pelvis
Fracture fixation, internal
Bone plate
3D printing
Template for titanium plate
