摘要
目的 :比较传统手术与应用3D打印技术后手术治疗对胫骨平台骨折的疗效。方法 :选择78例需手术治疗的胫骨平台骨折患者,根据随机数字表法分为3D技术组(n=39)和常规手术组(n=39)。3D技术组术前对骨折部位进行三维重建,3D打印出与骨折部位1∶1的实体模型,在模型上模拟手术,选择最佳复位、最匹配固定材料等,制定手术方案;常规手术组根据X射线及CT扫描影像资料制定手术方案,两组均按设计方案进行手术。对比两组患者住院时间、手术相关指标、住院费用、术后并发症及Rasmussen评分,评估3D打印技术手术对患者的影响。结果 :3D技术组患者的住院时间、手术时间、术中出血量、透视时间和骨折愈合时间均显著少于常规手术组,3D技术组患者创伤性关节炎、静脉血栓等并发症发生率也显著低于常规手术组,但3D技术组患者的住院费用显著高于常规手术组。Schatzker分型Ⅰ～Ⅲ的患者,两组患者的Rasmussen评分没有统计学差异;Schatzker分型Ⅳ～Ⅵ的患者,3D技术组的Rasmussen评分显著高于常规手术组。结论 :3D打印技术有助于复杂胫骨平台骨折手术方案的精确制定,能提高复位质量、减少手术时间,促进患者膝关节功能的恢复。
Objective Comparison of the effect of traditional surgery and 3 D printing technique in the treatment of tibial plateau fractures. Methods 78 cases of tibial plateau fractures with surgical treatment patients were selected and divided into 3 D technology group(n=39) and traditional surgery group(n=39) according to the random number table method. Three dimensional reconstruction of fracture site was performed in 3 D technology group before operation, 3 D prints out a solid model of 1∶1 with fracture site. In the model, the operation was simulated, and the best reduction, matching material and so on were selected. Surgical operation in traditional surgery group was designed according to X ray and CT scan data. The two groups were operated according to the design plan. The hospitalization time, operation-related indicators, hospitalization costs, postoperative complications and Rasmussen score between the two groups were compared, to evaluate the impact of 3 D printing technology on patients. Results The hospitalization time, operation time, intraoperative bleeding volume, fluoroscopy time and fracture healing time of the 3 D technique group were significantly less than those of the traditional surgery group. The incidence of traumatic arthritis, venous thrombosis and other complications in the 3 D technique group was significantly lower than that in the traditional surgery group, however, the cost of hospitalization in the 3 D technique group was significantly higher than that in the traditional surgery group. There was no significant difference in Rasmussen score between the two groups of patients with Schatzker type I-III. Rasmussen score of patients with Schatzker type IV-VI in the 3 D technology group was significantly higher than in the traditional surgery group. Conclusion 3 D printing technique is helpful to precisely formulate the operative plan for complex tibial plateau fractures, can improve the reduction quality, reduce the operation time and promote the recovery of knee joint function.
作者
连志远
马少波
李建
Lian Zhi-yuan;Ma Shao-bo;Li Jian(Orthopaedics department, The Second Hospital of Hanbin District in Ankang City, Ankang 725021, China;Orthopedics Hospital of Ankang Central Hospital, Ankang 725000, China)
出处
《湖南师范大学学报（医学版）》
2018年第6期76-79,共4页
Journal of Hunan Normal University(Medical Sciences)
关键词
胫骨平台骨折
3D打印技术
传统手术
tibial plateau fractures
3D printing technique
traditional surgery
