本文選題：-D打印技術(shù) + 脛骨骨折　； 參考：《中國修復(fù)重建外科雜志》2017年10期

【摘要】：目的探討3-D打印技術(shù)在青少年脛骨遠(yuǎn)端骨折累及骺板損傷手術(shù)中的應(yīng)用價(jià)值。方法回顧分析2014年1月—2015年12月采用3-D打印技術(shù)行手術(shù)治療的16例脛骨遠(yuǎn)端骨折累及骺板損傷患兒臨床資料。男12例,女4例;年齡9~14歲,平均12.8歲。致傷原因:交通事故傷9例,重物砸傷3例,運(yùn)動(dòng)傷4例。受傷至手術(shù)時(shí)間3~92 h,平均25.8 h。累及骺板的骨折按Salter-Harris進(jìn)行分型:Ⅱ型11例、Ⅲ型4例、Ⅵ型1例。術(shù)前對(duì)患肢行薄層CT掃描,應(yīng)用Mimics14.0醫(yī)學(xué)軟件進(jìn)行設(shè)計(jì),并使用3-D打印機(jī)打印出1∶1骨折模型;在骨折模型上模擬手術(shù)復(fù)位操作并選擇合適大小的接骨板、克氏針、空心螺釘,設(shè)計(jì)完整的手術(shù)入路、手術(shù)方式、選擇內(nèi)固定物,根據(jù)術(shù)前設(shè)計(jì)方案進(jìn)行實(shí)際手術(shù)。結(jié)果手術(shù)時(shí)間40~68 min,平均59.1 min;術(shù)中出血量5~102 mL,平均35 mL;術(shù)中透視次數(shù)2~6次,平均2.8次。16例患兒均獲隨訪,隨訪時(shí)間12~24個(gè)月,平均15個(gè)月。其中15例患兒骨折達(dá)解剖復(fù)位,1例骨折未解剖復(fù)位,斷端移位1 mm。術(shù)后患兒骨折均達(dá)骨性愈合,愈合時(shí)間2~4個(gè)月,平均2.6個(gè)月。均無下肢深靜脈血栓形成、骨骺早閉、踝關(guān)節(jié)面傾斜或不平發(fā)生,未并發(fā)骨髓炎,無踝關(guān)節(jié)內(nèi)外翻畸形、關(guān)節(jié)僵直、創(chuàng)傷性關(guān)節(jié)炎等并發(fā)癥發(fā)生。術(shù)后12個(gè)月行患肢踝關(guān)節(jié)功能Helfet評(píng)分,獲優(yōu)15例,良1例�；紓�(cè)內(nèi)外翻成角為(6.56±2.48)°,生長(zhǎng)長(zhǎng)度為(4.44±2.31)mm,與健側(cè)[(6.50±1.51)°、(4.69±1.08)mm]比較差異均無統(tǒng)計(jì)學(xué)意義(t=0.086,P=0.932;t=0.392,P=0.697)。結(jié)論 3-D打印技術(shù)作為輔助技術(shù),對(duì)改善脛骨遠(yuǎn)端骨折累及骺板損傷手術(shù)效果具有一定的臨床應(yīng)用價(jià)值。
[Abstract]:Objective to evaluate the value of 3-D printing technique in the treatment of distal tibial fractures involving epiphyseal plate injury. Methods from January 2014 to December 2015, the clinical data of 16 children with distal tibial fractures involved in epiphyseal plate injuries were retrospectively analyzed. There were 12 males and 4 females, aged 9 to 14 years (mean 12.8 years). The causes of injury were traffic accident in 9 cases, heavy object injury in 3 cases and sports injury in 4 cases. The average time from injury to operation was 25.8 hours. The fractures involving epiphyseal plate were classified according to Salter-Harris: 11 cases of type 鈪，

本文編號(hào)：1809631