本文選題：人工肘關(guān)節(jié)置換術(shù) + 肘關(guān)節(jié)假體　； 參考：《中國(guó)修復(fù)重建外科雜志》2017年04期

【摘要】：目的探討3-D打印導(dǎo)航模板輔助肘關(guān)節(jié)腫瘤切除并為患者定制個(gè)性化肘關(guān)節(jié)假體成功實(shí)施肘關(guān)節(jié)置換術(shù)的臨床方法。方法 2016年8月收治1例63歲左肱骨遠(yuǎn)端腫瘤男性患者。因發(fā)現(xiàn)左肱骨遠(yuǎn)端巨大包塊3個(gè)月余,伴肘關(guān)節(jié)疼痛、活動(dòng)受限入院。術(shù)前采用計(jì)算機(jī)輔助設(shè)計(jì)聯(lián)合3-D打印技術(shù),模擬腫瘤切除范圍,定制腫瘤切除模板以及用于修復(fù)腫瘤切除后骨缺損的同種異體骨修剪模板,同時(shí)設(shè)計(jì)個(gè)性化肘關(guān)節(jié)假體。術(shù)中按照設(shè)計(jì)精確切除腫瘤并行肘關(guān)節(jié)重建術(shù)。結(jié)果該例患者手術(shù)順利完成,術(shù)中腫瘤切除時(shí)間46 min,安裝個(gè)性化肘關(guān)節(jié)假體與同種異體骨時(shí)間95 min;術(shù)中無(wú)需透視。術(shù)后1周行X線片及CT檢查,示肘關(guān)節(jié)假體位置良好,尺骨假體前傾角為30°,肘關(guān)節(jié)提攜角為15°,與術(shù)前模擬肘關(guān)節(jié)置換術(shù)效果一致。術(shù)后1個(gè)月手指屈伸活動(dòng)正常,肘關(guān)節(jié)屈伸活動(dòng)范圍為0~130°,前臂旋前80°、旋后80°。術(shù)后7個(gè)月肘關(guān)節(jié)活動(dòng)滿足日常生活需要。腫瘤無(wú)復(fù)發(fā)、轉(zhuǎn)移。結(jié)論對(duì)于肘關(guān)節(jié)保肢術(shù),采用計(jì)算機(jī)輔助技術(shù)可實(shí)現(xiàn)術(shù)前模擬手術(shù)效果,通過(guò)制備導(dǎo)航模板提高了手術(shù)精準(zhǔn)度,定制個(gè)性化肘關(guān)節(jié)假體成功為患者實(shí)施了肘關(guān)節(jié)置換術(shù)從而重建肘關(guān)節(jié)功能,且具有術(shù)中無(wú)需X線透視、縮短手術(shù)時(shí)間等優(yōu)點(diǎn)。
[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(guān)節(jié)科;廣州中醫(yī)藥大學(xué)研究生院;廣東工業(yè)大學(xué);
【基金】：廣東省科技計(jì)劃項(xiàng)目(2013B021800050) 廣東省科技攻關(guān)項(xiàng)目(2013B021800055)~~
【分類號(hào)】：R738;TP391.73
，

本文編號(hào)：1980916