摘要
目的比较3D打印辅助微创手术与传统切开复位内固定术治疗SchatzkerⅤ、Ⅵ型胫骨平台骨折的临床疗效。方法回顾性分析168例SchatzkerⅤ、Ⅵ型胫骨平台骨折患者的临床资料,根据是否采用3D打印技术将168例患者分为3D打印微创手术组和常规手术组。3D打印微创手术组96例,骨折按照Schazker分型:Ⅴ型42例、Ⅵ型54例;常规手术组72例,骨折按照Schazker分型:Ⅴ型51例、Ⅵ型21例。观察并记录两组患者手术时间、出血量、切口长度、骨折愈合时间、并发症情况,术后随访时采用美国特种外科医院(hospital for special surgery,HSS)膝关节功能评分标准评估膝关节功能。结果 168例患者获得随访,所有患者达到骨性愈合,两组比较差异无统计学意义(P>0.05)。3D打印微创手术组手术时间(89.6±8.3)min、术中失血量(32.2±13.6)mL以及切口长度(11.2±3.6)cm明显少于常规手术组[(112.8±12.3) min,(57.1±23.7)mL,(15.8±2.1)cm],差异有统计学意义(P<0.05)。3D打印微创手术组末次随访HSS评分为65~95分,平均(93.1±4.8)分,优良率94.7%。结论基于3D打印技术的SchatzkerⅤ、Ⅵ型胫骨平台骨折微创治疗可以有效解决微创手术中的一些难点,达到与传统切开复位内固定相似的骨折愈合及功能恢复,同时切口更小,手术时间更短,手术相关并发症更少。
Objective To compare clinical efficacy between minimally invasive surgery based on 3 D print and conventional open plating for Schatzker Type Ⅴ and Ⅵ tibial plateau fractures. Methods A retrospective analysis was performed 168 patients with Schatzker Type Ⅴ and Ⅵ tibial plateau fractures in our department from July 2015 and July 2018. The patients were divided into 3 D based minimally invasive surgery group(Group A, n=96) and conventional open plating group(Group B, n=72) according to different surgical treatment. According to the Schazker classification, there were 42 cases of Schatzker Type Ⅴ and 54 cases of Type Ⅵ in Group A;and 51 cases of Schatzker Ⅴ and 21 of Type Ⅵ in Group B. The operative time, blood loss, length of incision, fracture healing time, and complications were observed and compared between two groups. The knee function was evaluated at the final follow-up using the Hospital for Special Surgery(HSS) score. Results Follow-up were completed in 168 patients, and all patients achieved bone healing. There was no significant difference between the two groups(P>0.05). The operation time was 89.6±8.3 min, intraoperative bleeding volume was 32.2±13.6 mL and length of incision was 11.2±3.6 cm in Group A, which were significantly less than those of Group B(112.8±12.3 min, 57.1±23.7 mL, and 15.8±2.1 cm, respectively, P<0.05). The mean HSS score was 93.1±4.8 at the final follow-up, and the excellent rate was 100%. Conclusion Minimally invasive treatment of Schatzker Type Ⅴ and Ⅵ tibial plateau fractures based on 3 D printing technology can effectively solve difficulties in minimally invasive surgery and achieve fracture healing and functional recovery similar to traditional open reduction and internal fixation;but providing shorter incision and the operation time, and less surgical complications.
作者
刘彦
区文欢
揭牧夫
陈丽君
陈述祥
LIU Yan;OU Wen-huan;JIE Mu-fu;CHEN Li-jun;CHEN Shu-xiang(The 2nd Department of orthopedic,Jiangmen TCM Affiliated Hospital of JI'nan University(Wuyi TCM Hospital of Jiangmen Guangdong),Jiangmen 529031,Guangdong,China)
出处
《广东医学》
CAS
2020年第4期358-364,共7页
Guangdong Medical Journal
基金
江门市科技计划项目(2017AC2013)。
关键词
3D打印
胫骨平台骨折
骨折固定术
3D printing technology
tibial platform
fracture fixation
