[1]张 建 ,宋 哲△ ,杨 娜 ,等.3D打印技术在复杂关节内骨折中的临床应用*[J].陕西医学杂志,2019,(3):322-325,329.
　ZHANG Jian,SONG Zhe,YANG Na,et al.Clinical application of 3D printing for the complex intraarticular fractures[J].,2019,(3):322-325,329.
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3D打印技术在复杂关节内骨折中的临床应用*
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《陕西医学杂志》[ISSN:1000-7377/CN:61-1281/TN]

卷:
期数:
2019年3期
页码:
322-325,329
栏目:
基础研究
出版日期:
2019-03-05

文章信息/Info

Title:
Clinical application of 3D printing for the complex intraarticular fractures
文章编号:
DOI:10.3969/j.issn.10007377.2019.03.010
作者:
张 建 1 ; 宋 哲2△ ; 杨 娜2 ; 王 晨2 ; 衡立松2 ; 樊 伟2; 朱养均2 ; 张 堃
1.陕西省渭南市中心医院（渭南 714000），2.西安交通大学附属红会医院（西安 710054）
Author(s):
ZHANG Jian;  SONG Zhe;  YANG Na;  et al.
Weinan Central Hospital in Shaanxi Province (Weinan714000)
关键词:
3D打印; 快速成型技术; 关节内; 骨折; 诊断; 治疗
Keywords:
Key words 3D printing;  Rapid prototyping technology; Intraarticular; Fracture; Diagnosis; Treatment
分类号:
R683.4
文献标志码:
A
摘要:
摘 要 目的：探讨3D打印技术在复杂关节内骨折的术前诊断、术前计划、预手术和术中治疗的可行性和临床意义。方法：收集复杂关节内骨折患者56例，进行3D模型的打印。骨折按部位分类：肱骨近端骨折9例；，复杂肘关节骨折脱位11例，肱骨远端骨折7例，骨盆及髋臼骨折16例，胫骨平台骨折7例，胫骨远端骨折6例。术前对每一个骨折患者进行螺旋CT扫描，将其DICOM数据输入，采用Mimics软件数据处理，应用3D打印技术打印骨折模型，制定手术方案，于内固定前模拟手术过程，然后根据预手术结果实施手术。结果：56例患者的术前诊断与术中所见一致，术中的手术方案完全采用了术前计划的内固定方法，术中采用的固定钢板、 螺钉数与螺钉长度均与术前计划基本一致。所有患者均获得了12～18个月的随访，术后随访影像学资料均显示骨折满意复位，内固定可靠且位置良好。术后随访患者功能结果满意。56例患者均获12～18个月（平均13.6个月）随访。所有患者术后内固定满意，骨折均顺利愈合。末次随访时，51例患者的关节功能恢复良好。结论： 3D打印技术对于粉碎的干骺端、关节面、陈旧性以及解剖复杂的关节内骨折患者，能够明确术前诊断，骨折类型，骨折移位的程度和骨折块大小，便于术中骨折的满意复位及良好固定，大大的提高了复杂关节内骨折的手术成功率。
Abstract:
Abstract Objective：To discuss the feasibility and clinical significance of the 3D printing technique in the preoperative diagnosis, preoperative planning, preoperation, and intraoperative treatment for the patients of complex intraarticular fractures. Methods：56 cases of the patients of complex intraarticular fractures were treated with 3D printing technique. There were 35 males and 21 females with an average age of 34.8(20～58) yearsold. According to fracture position: proximal humeral fracture, 9 cases; complex fracturedislocation of elbow joint, 11 cases; distal humeral fracture, 7 cases; acetabular and pelvic fracture, 16 cases ; tibial pleatue fracture, 7 cases ; distal tibial fracture, 6 cases. All the cases were examined by CTscan preoperatively. We input the DICOM data and process it with the Mimics software. Then we print the fracture model with 3D printing technique, made operation plan, simulate surgical procedure before the internal fixation, and implement the surgery according to the result of preoperation. Results：The preoperative diagnosis of 56 patients were accordant with the display of operation. The intraoperative surgical procedures were fully adopted the preoperative planning methods. The intraoperative plate, screw amounts and screw length were basically identical with the preoperative planning. 56 patients were followed up for 12 to 18 months (mean,13.6 months).The postoperative image data of all patients showed the satisfactory position of internal fixation and the bony healing. At the last followup, 51 patients got the perfect function of joint. Conclusion: 3D printing technique can clear preoperative diagnosis, fracture type, the degree of fracture displacement and the size of fracture fragments, for the orthopedic trauma patients with the comminuted metaphysial, articular surface, oboslete and complex anatomic intraarticular fractures, facilitate the satisfactory reduction and good fixation, and improve the success rates of orthopaedic traumatic surgery greatly.

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备注/Memo

备注/Memo:
*陕西省社会发展科技攻关项目（2015SF197）
更新日期/Last Update: 2019-03-15