摘要
背景:目前的肩胛骨骨折内固定手术受限于肩胛骨复杂的解剖结构,其手术难度大、出血多、耗时长。目的:观察3D打印技术应用于肩胛骨骨折手术的临床疗效。方法:回顾分析南京医科大学第二附属医院骨科于2016年1月至2018年12月收治的28例肩胛骨骨折患者(年龄34-70岁)临床资料,其中14例常规准备后手术(对照组),另14例患者行64排薄层CT扫描并进行三维重建,应用3D打印技术打印骨折模型,设计手术入路、定制内固定物后实施手术(3D打印组)。记录两组手术时间、术中出血量、术中X射线透视次数。术后6周随访复查影像学资料,根据Hardegger肩关节功能评定标准评定疗效。所有患者对治疗方案均知情同意,且得到医院伦理委员会批准。结果与结论:①28例手术均顺利完成,3D打印组手术时间、术中出血量及透视次数均少于对照组(P<0.05);②术后6周3D打印组肩关节评分优良率高于对照组(P<0.05);③3D打印组术中采用的手术入路、内固定物均与术前设计一致。3D打印技术应用肩胛骨骨折的手术治疗,有助于术者更好地了解肩胛骨骨折的特点和制定手术方案,降低手术难度,获得更为精准的复位,并减少手术时长、术中出血及术中X射线透视次数,提高了手术疗效。
BACKGROUND:The current internal fixation surgery for scapula fractures is limited by the complex anatomical structure of scapula,which is often difficult to operate,with much bleeding and time-consuming.OBJECTIVE:To observe the clinical efficacy of the application of 3D printing technology in scapula fracture surgery.METHODS:The clinical data of 28 cases(aged 34-70 years)with scapula fractures in the Second Affiliated Hospital of Nanjing Medical University from January 2016 to December 2018 were analyzed retrospectively.Among them,14 cases were treated after routine preparation(control group).Another 14 patients underwent 64-slice thin-slice CT scanning and 3D reconstruction.The fracture model was printed with 3D printing technology.The surgical approach was designed and the internal fixation was customized before the operation(3D printing group).The operation time,intraoperative blood loss and intraoperative X-ray frequency of the two groups were recorded.Imaging data were followed up six weeks after the operation.The treatment effects were evaluated according to the Hardegger shoulder joint function assessment standard.All patients signed the informed consent.This study was approved by the Hospital Ethics Committee.RESULTS AND CONCLUSION:(1)All the 28 operations were successfully completed.The operation time,intraoperative blood loss and X-ray frequency of the 3D printing group were all less than those of the control group(P<0.05).(2)The excellent and good rate of the 3D printing group was higher than that of the control group(P<0.05).(3)The operative approach and internal fixation used in the 3D printing group were consistent with the preoperative design.The application of 3D printing technology in the surgical treatment of scapula fractures can help surgeons better understand the characteristics of scapula fractures and make surgical plans,reduce the difficulty of surgery,obtain more accurate reduction,reduce the duration of surgery,intraoperative bleeding and intraoperative X-ray fluoroscopy,and improve the
作者
张涵
何斌
王伯尧
秦虎
王云华
范磊
Zhang Han;He Bin;Wang Boyao;Qin Hu;Wang Yunhua;Fan Lei(Department of Orthopedics,the Second Affiliated Hospital of Nanjing Medical University,Nanjing 210011,Jiangsu Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2020年第12期1864-1869,共6页
Chinese Journal of Tissue Engineering Research
基金
2017年江苏省级自然科学基金(青年科技人才专项基金)(BK20171092)，项目负责人：范磊~~
关键词
3D打印技术
肩胛骨骨折
骨折模型
定制内固定物
精准复位
术前规划
模拟手术
3D printing
scapula fractures
fracture models
designed internal fixator
accurate reduction
preoperative planning
simulated surgery
