摘要
目的探讨术前3D打印技术联合T型钢板弹性支撑固定治疗在后柱复杂性髋臼骨折患者中的应用效果。方法回顾性分析54例后柱复杂性髋臼骨折患者的临床资料,按手术方法将患者分为对照组和研究组,每组27例。两组患者均在全身麻醉下以Kocher-Langenbeck入路进行手术复位,对照组采用T型钢板弹性支撑固定治疗,研究组术前采用3D打印技术打印患者髋臼骨折模型指导治疗。比较两组患者手术指标(手术时间、术中出血量、术中输血量、术中透视次数)、骨折复位质量、髋关节功能恢复情况,以及围术期及随访期间并发症的发生情况。结果研究组手术时间、术中出血量、术中输血量及术中透视次数短于或少于对照组,骨折复位质量优良率高于对照组(P<0.05)。两组患者的Charnley髋关节功能评分差异有统计学意义(F组间=8.316,P组间<0.001),其中,术后3个月、6个月,研究组Charnley髋关节功能评分高于对照组(P<0.05);两组患者的Charnley髋关节功能评分有随时间变化的趋势(F时间=3.542,P时间=0.013),两组患者的Charnley髋关节功能评分随着时间延长而升高(P<0.05);分组与时间有交互效应(F交互=4.027,P交互=0.005)。围术期及随访期间,两组患者的伤口浅表感染、轻度异位骨化、创伤性关节炎、股骨头半脱位发生率比较,差异无统计学意义(P>0.05)。结论在以Kocher-Langenbeck入路进行手术复位治疗的基础上,采用术前3D打印技术联合T型钢板弹性支撑固定治疗后柱复杂性髋臼骨折患者可缩短手术时间,减少术中出血量、术中输血量及术中透视次数,提高骨折复位质量,有助于促进髋关节功能恢复,效果优于单纯T型钢板弹性支撑固定治疗,且安全性良好。
Objective To investigate the application effect of preoperative 3D printing technique combined with T-plate elastic support fixation therapy in patients with posterior column complex acetabular fracture.Methods The clinical data of 54 patients with posterior column complex acetabular fracture were retrospectively analyzed,and they were divided into control group or study group according to operative methods,with 27 cases in each group.Patients of both groups received operative reduction via Kocher-Langenbeck approach with general anesthesia,and the control group was treated with T-plate elastic support fixation,while the study group employed preoperative 3D printing technique to print patient′s acetabular fracture model for therapeutic guidance.The operative indices(operation duration,intraoperative bleeding volume,intraoperative blood transfusion volume,intraoperative fluoroscopic frequency),and fracture reduction quality,hip joint function recovery,as well as the occurrence of complications during perioperative period and follow-up were compared between patients of the two groups.Results The operative duration,intraoperative bleeding volume,intraoperative blood transfusion volume,and intraoperative fluoroscopic frequency of the study group were shorter or less than those of the control group,and fracture reduction quality was superior to that of the control group(P<0.05).There was statistically significant difference in Charnley hip joint function score between the two groups(F inter-group=8.316,P inter-group<0.001),therein,after 3 and 6 months of operation,the Charnley hip joint function score of the study group was higher than that of the control group(P<0.05);furthermore,the Charnley hip joint function score of the two groups interpreted a trend of change over time(F time=3.542,P time=0.013),the Charnley hip joint function score of the two groups was elevated by the time extension(P<0.05),and there was an interaction effect between grouping and time(F interaction=4.027,P interaction=0.005).There was no sta
作者
任原
刘弘扬
REN Yuan;LIU Hongyang(The First Department of Foot and Ankle Surgery,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China;Department of Geriatric Orthopedics,the Second Hospital of Tangshan,Tangshan 063000,Hebei,China)
出处
《广西医学》
CAS
2023年第20期2442-2446,2461,共6页
Guangxi Medical Journal
基金
河北省医学科学研究课题(20221737)。
关键词
后柱复杂性髋臼骨折
3D打印技术
T型钢板弹性支撑固定
手术指标
骨折复位质量
髋关节功能
Posterior column complex acetabular fracture
3D printing technique
T-plate elastic support fixation
Operative indices
Fracture reduction quality
Hip joint function
