發(fā)布時(shí)間：2018-04-11 07:46

  本文選題：-D打印技術(shù) + 截骨模塊　； 參考：《中國(guó)修復(fù)重建外科雜志》2016年04期

【摘要】：目的探討3-D打印技術(shù)輔助脛骨高位截骨術(shù)(high tibial osteotomy,HTO)治療膝內(nèi)翻畸形骨關(guān)節(jié)炎的臨床療效。方法 2014年1月-2015年6月,收治伴內(nèi)翻畸形的膝關(guān)節(jié)骨關(guān)節(jié)炎患者16例(20膝)。其中男6例,女10例;年齡30~60歲,平均45.5歲。病程1~10年,平均6.2年。單膝12例,雙膝4例。骨關(guān)節(jié)炎按照Koshino分級(jí)標(biāo)準(zhǔn):Ⅰ級(jí)3膝,Ⅱ級(jí)7膝,Ⅲ級(jí)8膝,Ⅳ級(jí)2膝。術(shù)前美國(guó)特種外科醫(yī)院(HSS)評(píng)分為(63.8±2.2)分;股脛角(femorotibial angle,FTA)為(184.8±2.9)°,髕骨高度Insall-Salvati指數(shù)(IS指數(shù))為1.03±0.13。術(shù)前于Mimics軟件中設(shè)計(jì)并3-D打印截骨導(dǎo)航模板,術(shù)中于模板輔助下行閉合楔形HTO后鎖定鋼板內(nèi)固定。結(jié)果患者術(shù)后切口均Ⅰ期愈合,無(wú)感染、骨筋膜間室綜合征、下肢深靜脈血栓形成等并發(fā)癥發(fā)生。16例均獲隨訪(fǎng),隨訪(fǎng)時(shí)間6~18個(gè)月,平均12.6個(gè)月。1例(1膝)術(shù)后出現(xiàn)腓神經(jīng)麻痹癥狀,經(jīng)對(duì)癥處理后癥狀緩解。X線(xiàn)片復(fù)查示,截骨處均骨性愈合,愈合時(shí)間2.7~3.4個(gè)月,平均2.9個(gè)月。術(shù)后6個(gè)月,FTA為(173.8±2.0)°,與術(shù)前比較差異有統(tǒng)計(jì)學(xué)意義(t=11.70,P=0.00);髕骨高度IS指數(shù)為1.04±0.12,與術(shù)前比較差異無(wú)統(tǒng)計(jì)學(xué)意義(t=—0.20,P=0.85);膝關(guān)節(jié)HSS評(píng)分為(88.9±3.1)分,與術(shù)前比較差異有統(tǒng)計(jì)學(xué)意義(t=—25.44,P=0.00)。末次隨訪(fǎng)時(shí),根據(jù)HSS評(píng)分標(biāo)準(zhǔn)評(píng)定療效:優(yōu)13膝,良6膝,可1膝,優(yōu)良率為95%。結(jié)論 HTO治療膝內(nèi)翻畸形骨關(guān)節(jié)炎時(shí),3-D打印截骨導(dǎo)航模板可精確輔助術(shù)中脛骨高位截骨,避免反復(fù)透視和多次截骨,可獲得滿(mǎn)意臨床療效。
[Abstract]:Objective to investigate the clinical effect of high tibial osteotomytomy osteoarthritis with 3-D printing technique in the treatment of knee varus deformity osteoarthritis.Methods from January 2014 to June 2015, 16 cases of knee osteoarthritis with varus deformity were treated.There were 6 males and 10 females, aged 30 to 60 years (mean 45.5 years).The course of disease ranged from 1 to 10 years, with an average of 6.2 years.There were 12 cases with single knee and 4 cases with double knee.According to Koshino classification criteria, 3 knees were grade 鈪，

本文編號(hào)：1735066