中国组织工程研究

中国组织工程研究 ›› 2025, Vol. 29 ›› Issue (33): 7123-7129.doi: 10.12307/2025.846

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

基于临床缺陷改进桡骨远端骨折3D打印夹板：设计及快速无网格分析

李国梁1，赵建勇2，吕德梁3，苏聚玥4，刘其林1，王铁强1，王  鑫5   

  1. 1河北省沧州中西医结合医院微创骨伤科，河北省沧州市   061001；2河北省中西医结合医学3D打印技术创新中心，河北省沧州市   061001；3河北中医药大学研究生学院，河北省石家庄市   050091；4澳汰尔工程软件(上海)有限公司，上海市   200070；5华北理工大学中医学院，河北省唐山市   063509
  • 收稿日期:2024-06-20 接受日期:2024-09-02 出版日期:2025-11-28 发布日期:2025-04-12
  • 通讯作者: 赵建勇，教授，博士生导师，主任医师，河北省中西医结合医学3D打印技术创新中心，河北省沧州市 061001
  • 作者简介:李国梁，男，1980年生，教授，硕士生导师，主任医师，主要从事数字化技术结合微创技术治疗骨创伤、中医手法的数字量化及中西医结合治疗骨创伤方面的研究。
  • 基金资助:
    河北省卫生健康委员会医学科学研究课题(20240655)，课题名称：基于数字设计及3D打印技术的桡骨远端骨折微创治疗方案研究，项目负责人：李国梁

Improved 3D printed splint for distal radius fracture based on clinical defects: design and rapid grid-free analysis

Li Guoliang1, Zhao Jianyong2, Lyu Deliang3, Su Juyue4, Liu Qilin1, Wang Tieqiang1, Wang Xin5   

  1. 1Department of Minimally Invasive Orthopedics, CangZhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province, Cangzhou 061001, Hebei Province, China; 2Hebei Provincial 3D Printing Technology Innovation Center of Integrated Traditional Chinese and Western Medicine, Cangzhou 061001, Hebei Province, China; 3Postgraduate School of Hebei University of Chinese Medicine, Shijiazhuang 050091, Hebei Province, China; 4Austelle Engineering Software (Shanghai) Co., Ltd., Shanghai 200070, China; 5College of Traditional Chinese Medicine, North China University of Science and Technology, Tangshan 063509, Hebei Province, China 
  • Received:2024-06-20 Accepted:2024-09-02 Online:2025-11-28 Published:2025-04-12
  • Contact: Zhao Jianyong, Professor, Doctoral supervisor, Chief physician, Hebei Provincial 3D Printing Technology Innovation Center of Integrated Traditional Chinese and Western Medicine, Cangzhou 061001, Hebei Province, China
  • About author:Li Guoliang, Professor, Master’s supervisor, Chief physician, Department of Minimally Invasive Orthopedics, CangZhou Hospital of Integrated Traditional Chinese and Western Medicine in Hebei Province, Cangzhou 061001, Hebei Province, China
  • Supported by:
    Medical Science Research Project of Hebei Provincial Health Commission, No. 20240655 (to LGL)

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摘要：


文题释义：

桡骨远端骨折：是指距桡骨远端关节面3 cm以内的骨折，该类骨折通常由于跌倒时用手支撑或因运动或意外事故直接受到冲击有关。其发病人群具有典型的双峰年龄分布，多见于年轻男性和老年女性，患者常表现出疼痛、肿胀、局部压痛和功能障碍。对于无移位或闭合复位后仍保持稳定的骨折、一些低需求患者的不稳定型骨折，常采用国内传统医学的闭合整复结合夹板或石膏固定的治疗方法；而对于极不稳定、粉碎性的关节内骨折则需要手术进行固定。
快速网格化分析：是指运用最新的无网格求解技术，使用多次自适应分析来控制分析结果，并且可以在全局或局部区域定义这种适应性控制。它无需进行传统的网格划分工作，极大地缩短了CAE仿真的工作周期。作为一个方便、易用、可以进行快速的力热分析和方案对比的工具，Altair SimSolid的特点在于支持大规模装配、前处理时间短、设置简便、计算速度快，且对硬件要求宽松。


背景：随着医疗技术的不断发展，桡骨远端骨折的治疗面临着更加精准化和个性化的需求。传统夹板固定方法在临床应用中存在一定的局限性，常出现固定不牢固、易于发生压疮等缺陷。采用快速无网格仿真技术验证改进的3D打印夹板的效能，有望为桡骨远端骨折带来更精准、更有效的治疗方案。

目的：探索基于临床缺陷改进的桡骨远端骨折3D打印夹板的设计方法，并采用快速无网格分析验证其临床效能。
方法：回顾性分析桡骨远端骨折夹板固定的临床缺陷，并针对性改进设计3D打印夹板，通过计算机辅助设计制图，制作出传统夹板和改进的新型3D打印夹板的数字模型。使用快速无网格分析工具进行仿真分析，计算总体、骨骼、软组织及夹板位移和应力分布情况。

结果与结论：①与传统夹板相比，改进的新型3D打印夹板对皮肤的压力比较均衡，具有较好的体表贴合性，没有明显的应力集中；位移更小、移动范围更合理；②通过对临床缺陷进行分析可以设计改进桡骨远端骨折3D打印夹板，快速无网格分析结果验证了改进3D夹板的优势，可为其临床应用提供依据。

https://orcid.org/0009-0004-2515-4732 (李国梁)

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

关键词: 桡骨远端骨折, 夹板, 3D打印, 快速无网格分析, 临床缺陷

Abstract: BACKGROUND: With the continuous development of medical technology, the treatment of distal radius fractures is facing the need for more precise and personalized treatment. The traditional splint fixation method has some limitations in clinical application, which often has defects such as unstable fixation and easy to occur pressure sores. The validation of the improved 3D printed splint with rapid grid-free simulation is expected to lead to more accurate and effective treatment options for distal radius fractures. 
OBJECTIVE: To explore the design method of 3D printed splint for distal radius fracture based on clinical defect improvement and verify its clinical efficacy by rapid grid-free analysis. 
METHODS: Clinical defects of splint fixation of extended distal radius fracture were retrospectively analyzed, and 3D printed small splint was designed with specific improvement. The digital models of traditional splint and improved new 3D printed splint were made by Computer Aided Design drawing. Total, bone, soft tissue, and splint displacement and stress distribution were calculated through simulation analysis using rapid grid-free analysis tools.  
RESULTS AND CONCLUSION: (1) Compared with the traditional splint, the improved new 3D printing splint exerteded more balanced pressure on the skin without obvious stress concentration, and had better body surface adhesion. The displacement was smaller and the movement range was more reasonable. (2) An 3D printed splint based on clinical defect improvement can be designed. Rapid grid-free analysis verifies the advantages of the improved 3D splint, providing a basis for clinical application. 

Key words: distal radius fracture, splint, 3D printing, rapid grid-free analysis, clinical defects

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