目的比较3D打印辅助经皮球囊扩张成形术(3D-PCP)与传统外侧L形延长入路切开复位内固定术(ORIF)治疗老年骨质疏松性跟骨SandersⅡ、Ⅲ型骨折的疗效。方法回顾性分析2012年6月至2018年6月江苏省宜兴市人民医院骨科手术治疗的36例老年骨质...目的比较3D打印辅助经皮球囊扩张成形术(3D-PCP)与传统外侧L形延长入路切开复位内固定术(ORIF)治疗老年骨质疏松性跟骨SandersⅡ、Ⅲ型骨折的疗效。方法回顾性分析2012年6月至2018年6月江苏省宜兴市人民医院骨科手术治疗的36例老年骨质疏松性跟骨SandersⅡ、Ⅲ型骨折患者资料。根据治疗方法不同分为2组:3D-PCP组16例,男9例,女7例;年龄(73.0±3.4)岁。ORIF组20例,男8例,女12例;年龄(71.4±2.6)岁。比较两组患者住院时间、手术时间、术中透视次数、拆线时间、下地负重时间、骨折愈合时间、术后2 d和术后1年手术部位疼痛视觉模拟(VAS)评分、术后1个月和1年美国足踝外科协会(AOFAS)的踝-后足评分、术后2 d和术后1年跟骨影像学参数(Böhler角、Gissane角、跟骨轴长、宽度、高度)、术后并发症发生情况等。结果两组患者术前一般资料比较均差异无统计学意义(P>0.05),具有可比性。所有患者术后获14~18个月(平均15.6个月)随访。与ORIF组相比,3D-PCP组住院时间短、手术时间短、拆线时间早、下地负重时间早,术后2 d VAS评分低,术后1个月AOFAS的踝-后足评分高,但术中透视次数多,差异均有统计学意义(P<0.05)。所有患者术后2 d VAS评分低于术前,术后1年VAS评分低于术后2 d,差异均有统计学意义(P<0.05)。所有患者术后1个月AOFAS的踝-后足评分均高于术前,差异有统计学意义(P<0.001);其中ORIF组术后1年AOFAS的踝-后足评分高于术后1个月,差异有统计学意义(P<0.05);但3D-PCP组术后1个月和术后1年无差异(P>0.05)。两组患者间术后1年VAS评分、AOFAS的踝-后足评分、骨折愈合时间、术后影像学参数比较差异均无统计学意义(P>0.05)。两组患者并发症发生情况比较差异无统计学意义(P>0.05)。结论采用3D-PCP治疗老年骨质疏松性跟骨SandersⅡ、Ⅲ型骨折虽增加术中透视次数,但具有手术时间短、创伤小、切口愈合快、展开更多
Three dimensional （3D） printing technology was utilized to fabricate a new type of drug implant with complicated architectures, employing levofloxacin （LVFX） and rifampicine （RFP） as model drugs. The prepared dr...Three dimensional （3D） printing technology was utilized to fabricate a new type of drug implant with complicated architectures, employing levofloxacin （LVFX） and rifampicine （RFP） as model drugs. The prepared drug implant prototype consists of a doublelayer structure, of which the upper region is a reservoir system containing RFP and the lower region is a matrix one containing LVFX. The release test in vivo revealed that LVFX was released in the early stage; no RFP was detected until 8th day; both of them continuously released more than 6 weeks. Therefore, 3D printing technology provides a precise and feasible method to fabricate a controlled-releasing drug implant with complicated architectures and this drug implant may present a new strategy for the prophylaxis and treatment of bone diseases such as combined bone infections and bone tuberculosis in the near future.展开更多
文摘目的比较3D打印辅助经皮球囊扩张成形术(3D-PCP)与传统外侧L形延长入路切开复位内固定术(ORIF)治疗老年骨质疏松性跟骨SandersⅡ、Ⅲ型骨折的疗效。方法回顾性分析2012年6月至2018年6月江苏省宜兴市人民医院骨科手术治疗的36例老年骨质疏松性跟骨SandersⅡ、Ⅲ型骨折患者资料。根据治疗方法不同分为2组:3D-PCP组16例,男9例,女7例;年龄(73.0±3.4)岁。ORIF组20例,男8例,女12例;年龄(71.4±2.6)岁。比较两组患者住院时间、手术时间、术中透视次数、拆线时间、下地负重时间、骨折愈合时间、术后2 d和术后1年手术部位疼痛视觉模拟(VAS)评分、术后1个月和1年美国足踝外科协会(AOFAS)的踝-后足评分、术后2 d和术后1年跟骨影像学参数(Böhler角、Gissane角、跟骨轴长、宽度、高度)、术后并发症发生情况等。结果两组患者术前一般资料比较均差异无统计学意义(P>0.05),具有可比性。所有患者术后获14~18个月(平均15.6个月)随访。与ORIF组相比,3D-PCP组住院时间短、手术时间短、拆线时间早、下地负重时间早,术后2 d VAS评分低,术后1个月AOFAS的踝-后足评分高,但术中透视次数多,差异均有统计学意义(P<0.05)。所有患者术后2 d VAS评分低于术前,术后1年VAS评分低于术后2 d,差异均有统计学意义(P<0.05)。所有患者术后1个月AOFAS的踝-后足评分均高于术前,差异有统计学意义(P<0.001);其中ORIF组术后1年AOFAS的踝-后足评分高于术后1个月,差异有统计学意义(P<0.05);但3D-PCP组术后1个月和术后1年无差异(P>0.05)。两组患者间术后1年VAS评分、AOFAS的踝-后足评分、骨折愈合时间、术后影像学参数比较差异均无统计学意义(P>0.05)。两组患者并发症发生情况比较差异无统计学意义(P>0.05)。结论采用3D-PCP治疗老年骨质疏松性跟骨SandersⅡ、Ⅲ型骨折虽增加术中透视次数,但具有手术时间短、创伤小、切口愈合快、
基金Funded by the Graduate Innovation Fund of the Huazhong University of Science and Technology, the "863" Key Project of the National High Technology Research and Development Program of China (No.2006AA02A124)the Program for New Century Excellent Talents in University from the Ministry of Education of China( NCET-05-0647)
文摘Three dimensional （3D） printing technology was utilized to fabricate a new type of drug implant with complicated architectures, employing levofloxacin （LVFX） and rifampicine （RFP） as model drugs. The prepared drug implant prototype consists of a doublelayer structure, of which the upper region is a reservoir system containing RFP and the lower region is a matrix one containing LVFX. The release test in vivo revealed that LVFX was released in the early stage; no RFP was detected until 8th day; both of them continuously released more than 6 weeks. Therefore, 3D printing technology provides a precise and feasible method to fabricate a controlled-releasing drug implant with complicated architectures and this drug implant may present a new strategy for the prophylaxis and treatment of bone diseases such as combined bone infections and bone tuberculosis in the near future.
