| 术前虚拟规划联合3D打印模板预塑形钢板治疗髋臼后壁骨折 |
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投稿时间：2023-02-16
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| 作者 | Author | 单位 | Address | E-Mail |
| 黄晨 |
HUANG Chen |
西部战区总医院骨科, 四川 成都 610083 |
Department of Orthopaedics, General Hospital of Western Theater Command, Chengdu 610083, Sichuan, China |
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| 徐伟 |
XU Wei |
西部战区总医院骨科, 四川 成都 610083 |
Department of Orthopaedics, General Hospital of Western Theater Command, Chengdu 610083, Sichuan, China |
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| 谢美明 |
XIE Mei-ming |
西部战区总医院骨科, 四川 成都 610083 |
Department of Orthopaedics, General Hospital of Western Theater Command, Chengdu 610083, Sichuan, China |
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| 王财儒 |
WANG Cai-ru |
西部战区总医院骨科, 四川 成都 610083 |
Department of Orthopaedics, General Hospital of Western Theater Command, Chengdu 610083, Sichuan, China |
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| 邓少林 |
DENG Shao-lin |
西部战区总医院骨科, 四川 成都 610083 |
Department of Orthopaedics, General Hospital of Western Theater Command, Chengdu 610083, Sichuan, China |
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| 廖冬发 |
LIAO Dong-fa |
西部战区总医院骨科, 四川 成都 610083 |
Department of Orthopaedics, General Hospital of Western Theater Command, Chengdu 610083, Sichuan, China |
1532907286@qq.com |
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| 期刊信息：《中国骨伤》2024年，第37卷，第2期，第135-141页 |
| DOI：10.12200/j.issn.1003-0034.20220508 |
| 基金项目:军委后勤保障部面上项目（编号：19BJZ11） |
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中文摘要:
目的：评估虚拟术前规划和3D打印模板预塑形钢板治疗髋臼后壁骨折的可行性和准确性。
方法：回顾性分析2017年8月至2020年8月治疗的髋臼后壁骨折患者29例，根据是否采用术前虚拟规划和3D打印模板分为2组，3D打印组14例，男10例，女4例；年龄21~53岁；基于患者骨盆CT数据采用Mimics和3-Matic软件进行虚拟手术规划，虚拟复位骨折，设计后壁钢板模板及螺钉固定位置，模拟透视记录合适方位以指导术中透视，打印后壁钢板模板和带有后壁骨折块的钢板螺钉模型，然后根据模板预塑形钢板备用。常规组15例，男10例，女5例；年龄19~55岁；采用常规的方法术中折弯钢板适应骨折区域。比较两组术中出血量、手术时间、骨折复位质量和髋关节功能。
结果：23例患者获得随访，时间12~30个月。两组患者骨折均愈合，愈合时间3~6个月。两组手术时间、术中出血量比较，差异均有统计学意义（P<0.05）。末次随访时髋关节功能Merle d'Aubign-Postel评分，3D打印组疼痛程度评分低于常规组（P<0.05）；两组行走能力、髋关节活动度和总分比较，差异均无统计学意义（P>0.05）。3D打印组优6例，良5例，可3例；常规组优5例，良5例，可4例，差1例；两组髋关节功能疗效比较，差异无统计学意义（P>0.05）。
结论：术前虚拟规划结合3D打印模板预塑形钢板技术可缩手术时间，减少手术出血量，提高复位质量。该技术治疗髋臼后壁骨折有效、准确、可靠。 |
| 【关键词】髋臼后壁骨折 术前虚拟计划 3D打印 预塑形 |
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| Virtual preoperative planning and 3D-printed templates for pre-contoured plates in treatment of acetabular posterior wall fractures |
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ABSTRACT
Objective To evaluate the feasibility and accuracy of virtual preoperative planning and 3D-printed templates for pre-contoured plates for the treatment of posterior wall fractures of the acetabulum.
Methods A retrospective analysis of 29 patients with posterior acetabular wall fractures treated between August 2017 and March 2021 were divided into 2 groups based on whether to use preoperative virtual planning and 3D printed template. In 3D-printing group, there were 14 patients, including 10 males and 4 females; aged from 21 to 53 years old;CT-based virtual surgical planning was done using Mimics and 3-Matic software and 3D-printed templates for pre-contoured plates were adopted. In conventional group, there were 15 patients, including 10 males and 5 females;aged from 19 to 55 years old;conventional method of intra-operative contouring to adapt the plate to the fracture region was adopted. Blood loss, surgical time, radiographic quality of reduction, and hip function were compared between groups.
Results The difference in operation time and intraoperative blood loss was significant(P<0.05). Twenty-three patients were followed up from 12 to 30 months, and the fractures in both groups healed with a healing time of 3 to 6 months. At the last follow-up, the Merle d'Aubign-Postel score of the 3D printed group was lower than that of the conventional group(P<0.05), with no significant differences in walking ability, hip mobility and total score(P>0.05). In 3D printing group, 6 cases were excellent, 5 cases were good, 3 cases were fair;in conventional group, 5 cases were excellent, 5 cases were good, 4 cases were fair, 1 case was worse;no significant difference between two groups(P>0.05).
Conclusion Virtual preoperative planning and 3D-printed templates for pre-contoured plates can reduce operative time and the blood loss of surgery, improve the quality of reduction. This method is efficient, accurate and reliable to treat acetabular posterior wall fractures. |
| KEY WORDS Acetabulum posterior wall fracture Pre-operative virtual planning Three-dimensional printing Pre-contoured |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 黄晨,徐伟,谢美明,王财儒,邓少林,廖冬发.术前虚拟规划联合3D打印模板预塑形钢板治疗髋臼后壁骨折[J].中国骨伤,2024,37(2):135~141 |
| 英文格式: | HUANG Chen,XU Wei,XIE Mei-ming,WANG Cai-ru,DENG Shao-lin,LIAO Dong-fa.Virtual preoperative planning and 3D-printed templates for pre-contoured plates in treatment of acetabular posterior wall fractures[J].zhongguo gu shang / China J Orthop Trauma ,2024,37(2):135~141 |
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