摘要
目的探讨3D打印模型个性化治疗肩胛骨粉碎性骨折的疗效。方法自2018年4月至2019年10月我科采用3D打印模型个性化治疗10例肩胛骨粉碎性骨折患者。其中肩胛骨体部骨折6例,肩胛盂骨折2例,累及肩胛骨体部、肩胛冈骨折2例。术前均行CT三维重建,数据输入3D打印机后实施3D打印,制作肩胛骨骨折模型,根据模型确定手术方案。采用改良的Judet肩后方入路6例,外侧Hardegger入路4例。根据影像学评价观察骨折愈合情况,采用Constant-Murley肩关节评分系统及Neer肩关节功能评定系统评估肩关节功能情况。结果本组手术时间60~120 min,平均(76.11±18.53)min;术中出血量40~70 ml,平均(52.22±10.93)ml。切口均Ⅰ期愈合,无红肿热痛等情况发生。骨折均愈合,时间为4~8周,平均6周。所有患者均获得6~18个月随访,平均12个月。随访期内无骨折块移位、螺钉松动或钢板断裂、切口感染等并发症发生。采用Constant-Murley肩关节评分系统评分:优9例,良1例;采用Neer肩关节功能评定系统评分:优9例,良1例。结论结合3D打印模型个性化治疗肩胛骨粉碎性骨折,可以在术前演练手术方案,术中减少对软组织的过多剥离,手术时间短,出血量少,并发症少,术后骨折愈合快,配合良好的康复锻炼,肩关节功能恢复好,疗效确切。
Objective To explore the effects of personalized 3D printing model in the treatment of comminuted scapular fractures.Methods From April 2018 to October 2019,10 patients with comminuted scapular fractures received personalized treatment with a 3D printed model.There were 6 cases of scapular body fractures,2 cases of scapular glenoid fractures,and 2 cases of scapular body and scapular blade fractures.All patients underwent CT three-dimensional reconstruction before operation.After the data were input into the 3D printer,3D printing was implemented to make the scapular fracture model,and the operation scheme was determined according to the model.The modified Judet posterior shoulder approach was used in 6 cases and the lateral Hardegger approach in 4 cases.The fracture healing was observed according to imaging evaluation,and the shoulder function was evaluated by Constant-Murley shoulder scoring system and Neer shoulder function evaluation system.Results The operation time was 60 to 120 min,with an average of(76.11±18.53)minutes.The amount of intraoperative bleeding was 40 to 70 ml,with an average of(52.22±10.93)ml.All the incisions achieved primary healing without redness,swelling,heat and pain.All the fractures healed for 4 to 8 weeks,with an average of 6 weeks.All the patients were follow-up for 6 to 18 months,with an average of 12 months.During the follow-up period,there were no complications such as fracture block displacement,screw loosening,steel plate fracture and incision infection.Using the Constant-Murley shoulder scoring system,9 cases were excellent,and 1 case was good.Using the Neer shoulder function evaluation system,9 cases were excellent,and 1 case was good.Conclusion The personalized treatment of scapular comminuted fracture combined with 3D printing model can practice the operation scheme before operation,reduce excessive stripping of soft tissue during operation with short operation time,less bleeding,less complications,fast postoperative fracture healing.Combined with good rehabilitation exerc
作者
胡海洋
巨积辉
金光哲
张笑
张广亮
王臻
Hu Haiyang;Ju Jihui;Jin Guangzhe;Zhang Xiao;Zhang Guangliang;Wang Zhen(Department of Orthopedics,Ruihua Affiliated Hospital of Suzhou University,Suzhou 215104,China)
出处
《中华手外科杂志》
CSCD
北大核心
2021年第6期414-417,共4页
Chinese Journal of Hand Surgery
基金
江苏省青年医学人才项目(QNRC2016224)。
关键词
肩胛骨
骨折
3D打印技术
导板
Scapula
Fractures,bone
3D print technology
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