本文選題：人工肘關節(jié)置換術 + 肘關節(jié)假體�。� 參考：《中國修復重建外科雜志》2017年04期

【摘要】：目的探討3-D打印導航模板輔助肘關節(jié)腫瘤切除并為患者定制個性化肘關節(jié)假體成功實施肘關節(jié)置換術的臨床方法。方法 2016年8月收治1例63歲左肱骨遠端腫瘤男性患者。因發(fā)現(xiàn)左肱骨遠端巨大包塊3個月余,伴肘關節(jié)疼痛、活動受限入院。術前采用計算機輔助設計聯(lián)合3-D打印技術,模擬腫瘤切除范圍,定制腫瘤切除模板以及用于修復腫瘤切除后骨缺損的同種異體骨修剪模板,同時設計個性化肘關節(jié)假體。術中按照設計精確切除腫瘤并行肘關節(jié)重建術。結果該例患者手術順利完成,術中腫瘤切除時間46 min,安裝個性化肘關節(jié)假體與同種異體骨時間95 min;術中無需透視。術后1周行X線片及CT檢查,示肘關節(jié)假體位置良好,尺骨假體前傾角為30°,肘關節(jié)提攜角為15°,與術前模擬肘關節(jié)置換術效果一致。術后1個月手指屈伸活動正常,肘關節(jié)屈伸活動范圍為0~130°,前臂旋前80°、旋后80°。術后7個月肘關節(jié)活動滿足日常生活需要。腫瘤無復發(fā)、轉移。結論對于肘關節(jié)保肢術,采用計算機輔助技術可實現(xiàn)術前模擬手術效果,通過制備導航模板提高了手術精準度,定制個性化肘關節(jié)假體成功為患者實施了肘關節(jié)置換術從而重建肘關節(jié)功能,且具有術中無需X線透視、縮短手術時間等優(yōu)點。
[Abstract]:Objective to investigate the clinical method of elbow arthroplasty with 3-D printed navigation template assisted elbow tumor resection and customized personalized elbow prosthesis. Methods A 63-year-old male patient with left distal humeral tumor was treated in August 2016. The left distal humeral mass was found to be large for more than 3 months, accompanied by pain in the elbow joint and limited movement. Computer aided design (CAD) combined with 3-D printing technique was used to simulate the range of tumor resection, to customize the tumor removal template, and to design a personalized elbow prosthesis. The tumor was resected accurately and the elbow joint was reconstructed according to the design. Results the operation was completed successfully, the tumor resection time was 46 min, and the time of individualized elbow prosthesis and allograft bone was 95 min. No fluoroscopy was required during the operation. One week after operation, X-ray and CT examination showed that the position of elbow prosthesis was good, the antegrade angle of ulnar prosthesis was 30 擄and the carrying angle of elbow joint was 15 擄, which was consistent with the effect of simulated elbow arthroplasty before operation. The finger flexion and extension activity was normal 1 month after operation. The range of flexion and extension of elbow joint was 0 擄130 擄, forearm pronation 80 擄and pronation 80 擄. 7 months after operation, elbow joint activities met the needs of daily life. There was no recurrence and metastasis. Conclusion for limb salvage of elbow joint, computer aided technique can be used to simulate the operation before operation, and the accuracy of operation can be improved by making navigation template. The customized elbow prosthesis was successfully performed to reconstruct the function of the elbow joint in order to reconstruct the function of the elbow joint. It also has the advantages of no X-ray fluoroscopy during the operation and the shortening of the operation time and so on.
【作者單位】： 廣州軍區(qū)廣州總醫(yī)院骨病關節(jié)科;廣州中醫(yī)藥大學研究生院;廣東工業(yè)大學;
【基金】：廣東省科技計劃項目(2013B021800050) 廣東省科技攻關項目(2013B021800055)~~
【分類號】：R738;TP391.73
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本文編號：1980916