中国组织工程研究

中国组织工程研究 ›› 2019, Vol. 23 ›› Issue (12): 1859-1863.doi: 10.3969/j.issn.2095-4344.1124

• 数字化骨科 digital orthopedics • 上一篇    下一篇

3D打印骨折模型在复杂股骨远端骨折修复中的应用价值

黄智勇1，苏丽萍2，蓝孝全3，郭 强2，马建林1，黄佳军1，赵敦旭1，邢建龙1，纪 翔1，招 明1   

  1. 青岛市城阳区人民医院，泰山医学院附属青岛医院，1骨创伤科，2骨关节科，3 3D打印医学转化中心，山东省青岛市  266109
  • 出版日期:2019-04-28 发布日期:2019-04-28
  • 通讯作者: 马建林，主任医师，青岛市城阳区人民医院，泰山医学院附属青岛医院骨创伤科，山东省青岛市 266109
  • 作者简介:黄智勇，男，汉族，1963年生，山东省潍坊市人，主任医师。
  • 基金资助:

    国家卫计委医药卫生科研指导计划(W2015QJ019)，项目负责人：马建林；青岛市医药科研指导计划(2016-WJZD124)，项目负责人：黄智勇；“青岛市医疗卫生重点学科建设项目资助”(QDZDXK-B-2017063)，项目负责人：马建林

Value of three-dimensional printed fracture model in the repair of complicated distal femoral fractures  

Huang Zhiyong1, Su Liping2, Lan Xiaoquan3, Guo Qiang2, Ma Jianlin1, Huang Jiajun1, Zhao Dunxu1, Xing Jianlong1, Ji Xiang1, Zhao Ming1   

  1. 1Department of Traumatic Orthopedics, 2Department of Bone and Joint, 3Center of 3D Printing Translational Medicine, Chengyang People’s Hospital of Qingdao & Qingdao Hospital Affiliated to Taishan Medical University, Qingdao 266109, Shandong Province, China
  • Online:2019-04-28 Published:2019-04-28
  • Contact: Ma Jianlin, Chief physician, Department of Traumatic Orthopedics, Chengyang People’s Hospital of Qingdao & Qingdao Hospital Affiliated to Taishan Medical University, Qingdao 266109, Shandong Province, China
  • About author:Huang Zhiyong, Chief physician, Department of Traumatic Orthopedics, Chengyang People’s Hospital of Qingdao & Qingdao Hospital Affiliated to Taishan Medical University, Qingdao 266109, Shandong Province, China
  • Supported by:

    the Medical and Health Research Guidance Plan of National Health Commission of China, No. W2015QJ019 (to MJL); the Medical and Health Research Guidance Plan of Qingdao, No. 2016-WJZD124 (to HZY); the Major Medical and Health Construction Project of Qingdao, No. QDZDXK-B-2017063 (to MJL)

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摘要：

文章快速阅读：

 
 
文题释义：
3D打印技术：属于快速成形技术的一种，它是一种数字模型文件为基础，运用粉末状金属或塑料等可黏合材料，通过逐层堆叠累积的方式来构造物体的技术(即“积层造形法”)。3D打印技术在多种骨折的辅助治疗中其重要作用。
3D打印技术的临床应用：临床研究发现该技术能立体、客观的呈现骨折情况，通过1∶1实物还原骨折断端，进而帮助临床医生评估病情，设计手术方案。
 
摘要
背景：虽然有研究提示3D打印技术适用于多种骨折的辅助治疗，但该技术是否适用于复杂股骨远端骨折仍有待商榷。
目的：探讨3D打印骨折模型在复杂股骨远端骨折修复中的应用价值。
方法：患者均来源于泰山医学院附属青岛医院，均因复杂股骨远端骨折就诊并接受手术治疗，共纳入患者107例，其中患者51例接受常规内固定修复设为常规组，患者56例在常规复位手术前结合3D打印技术预处理设为3D组。随访1.0-1.5年。
结果与结论：①与常规组比，3D组在手术期间用时明显缩短，出血量明显减少，术中需要的透视次数明显减少，术后引流量较少，出院时间较早(P < 0.05)；②术毕X射线显示骨折复位方面，3D组的满意度为85.7%，虽略高于常规组的78.4%，但差异无显著性意义(P > 0.05)；③在评级骨性愈合上，两组骨性愈合时间相当(P > 0.05)。术后1年进行恢复效果HSS评级评价，3D组HSS评级优良率为91.1%，虽然略优于常规组的84.3%，但差异无显著性意义(P > 0.05)；④不良反应方面，3D组不良反应总发生率为12.5%，明显低于常规组的31.4%(P < 0.05)；⑤结果证实，与常规复位手术比较，常规复位手术前结合3D打印技术预处理可节省复杂股骨远端骨折患者手术时间，降低术中出血情况，术后疗效相当，安全性更好。

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程
ORCID: 0000-0002-0143-3751(黄智勇)

关键词: 复杂股骨远端骨折, 常规复位手术, 3D打印, 骨折模型, 模拟骨折复位内固定, X射线骨折复位, 骨折愈合评价

Abstract:

BACKGROUND: Three-dimensional printing has been shown to be available for the auxiliary technology in various bone fractures, but whether it can be applied in the surgery of complicated distal femoral fracture remains unclear.

OBJECTIVE: To investigate the value of three-dimensional printed fracture models in the repair of complicated distal femoral fractures.
METHODS: One hundred and seven patients with complicated distal femoral fractures and received surgical treatment at the Qingdao Hospital Affiliated to Taishan Medical University were included. Among them, 51 patients underwent conventional internal reduction (conventional group) and 56 patients underwent three-dimensional printing technology before reduction (three-dimensional printing group). All patients were followed up for 1.0-1.5 years.
RESULTS AND CONCLUSION: (1) Compared with the conventional group, the operation time, blood loss, times of fluoroscopy, postoperative drainage volume and hospitalization time were significantly decreased in the three-dimensional printing group (P < 0.05). (2) X-ray immediately postoperatively showed fracture reduction, 85.7% satisfaction in the three-dimensional printing group, slightly higher than that in the conventional group (78.4%) (P > 0.05). (3) There was no significant difference in the healing time between two groups (P > 0.05). The excellent and good rate in Hospital for Special Surgery scores at 1 year postoperatively in the three-dimensional printing group (91.1%) was slightly higher than that in the conventional group (84.3%) (P > 0.05). (4) The total incidence of adverse reaction in the three-dimensional printing group (12.5%) was significantly lower than that in the conventional group (31.4%) (P < 0.05). (5) Our results indicate that three- dimensional printing technique can reduce the operation time, and intraoperative blood loss, same treatment outcomes and good safety for complicated distal femoral fractures compared with the conventional surgery.

Key words: Tissue Engineering, Femoral Fractures, Fracture Healing

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