摘要
目的探讨3D打印个体化钛网治疗粉碎性髌骨骨折的临床疗效,为粉碎性髌骨骨折的治疗提供一种有效的新方法。方法回顾性分析该院自2016年11月-2019年1月收治的17例粉碎性髌骨骨折患者,分别采用3D钛网和克氏针张力带治疗,从术中情况、术后并发症和术后6个月改良Bostman髌骨骨折功能评分等方面进行比较。结果 3D钛网固定组患者手术时间平均70 min,出血量平均27.5 mL;克氏针张力带固定组患者手术时间平均62.5 min,出血量平均30 mL。3D钛网固定组在术后随访中无术区触痛,无出现皮肤高突,无内固定断裂,依据术后6个月改良Bostma评分,4例患者均优,优良率达100%。克氏针张力带固定组在术后随访中,3例出现术区触痛,2例出现皮肤高突,1例出现内固定断裂,依据术后6个月改良Bostma评分标准,优7例(53.8%),良4例(30.8%),差2例(15.4%),优良率为84.6%。结论 3D打印个体化钛网内固定方式固定可靠,贴合患者髌骨解剖,并发症少,操作更为简便,可有效治疗多种类型的髌骨骨折,特别是在高度粉碎性骨折和伴有骨质疏松的患者治疗中更具优势。
Objective To investigate the clinical efficacy of 3 D printed individualized titanium mesh in the treatment of comminuted patella fractures,and to provide an effective new method for the treatment of comminuted patella fractures.Methods A retrospective analysis of 17 patients with comminuted patella fractures admitted to our hospital from 2016 to 2019 were treated with 3 D titanium mesh and Kirschner wire tension band.The conditions during the operation,postoperative complications and 6 months after the operation were analyzed.The modified Bostman patella fracture function score and other aspects were compared.Results The average op-eration time of the 3 D titanium mesh fixation group was 70 min,and the average blood loss was 27.5 mL;the average operation time of the Kirschner wire tension band fixation group was 62.5 min,and the average blood loss was 30 mL.In the 3 D titanium mesh fixation group,there was no tenderness in the operation area,no skin protrusions,and no internal fixation breaks in the postoperative follow-up.According to the modified Bostma score at 6 months after surgery,all 4 patients were excellent,and the excellent and good rate reached 100%.In the Kirschner wire tension band fixation group,during the postoperative follow-up,3 cases had tenderness in the operation area,2 cases had skin hyperprotrusion,and 1 case had internal fixation rupture.According to the 6-month modified Bostma score standard,7 cases were excellent(53.8%),good 4 cases(30.8%),poor 2 cases(15.4%),the excellent and good rate was84.6%.Conclusion The 3 D printed individualized titanium mesh internal fixation method is reliable and fits the patient’s patella anatomy,has fewer complications,and is easier to operate.It can effectively treat various types of patella fractures,especially in high-ly comminuted fractures and accompanied by bone.The treatment of loose patients has more advantages.
作者
王彦波
谢达
高定
田涛
谌业光
WANG Yan-bo;XIE Da;GAO Ding;TIAO Tao;CHEN Ye-guang(Orthopedic Center,Meizhou People's Hospital,Meizhou,Guangdong Province,514000 China)
出处
《世界复合医学》
2020年第8期189-192,共4页
World Journal of Complex Medicine
关键词
粉碎性髌骨骨折
3D打印个体化钛网
克氏针张力带
Comminuted patella fracture
3D printed individualized titanium mesh
Kirschner wire tension band
