【摘要】：[目的]探討3D打印四肢關節(jié)腫瘤假體在四肢大關節(jié)腫瘤手術治療中的新方法。[方法]2014年1月~2016年5月在本院接受治療的四肢關節(jié)骨腫瘤患者共6例,全部患者術前都對興趣區(qū)域行CT掃描(層厚為1.0mm),獲得平面圖像信息,再通過三維重建,得到DICOM格式數(shù)據(jù),將數(shù)據(jù)導入Mimics 17.0軟件中,編輯三維立體模型,在模型上確定截骨部位,并設計與剩余骨組織匹配的內(nèi)置物假體,包括鈦合金假體的孔徑、密度及孔隙度,新的韌帶附麗點。隨訪時利用國際骨骼肌肉腫瘤保肢(MSTS)功能評分系統(tǒng)對患者的預后進行評估。[結(jié)果]所有患者都獲得隨訪,隨訪時間4~25個月,平均13.2個月,術后經(jīng)X線片證實剩余骨組織與腫瘤型假體匹配良好,未見假體松動及骨溶解,未見腫瘤復發(fā)及轉(zhuǎn)移,6例患者仍存活,各關節(jié)功能恢復良好,最后一次隨訪時MSTS得分為17~28分,平均25.7分,其中優(yōu)3例,良2例,可1例,優(yōu)良率達83.3%。[結(jié)論]通過3D打印技術的應用,可確定精確截骨范圍,設計個體化關節(jié)假體,調(diào)整鈦合金假體的孔徑、密度及孔隙度,在假體上設計個體化韌帶附麗點,使之接近正常生理解剖,術后關節(jié)功能良好,為治療四肢關節(jié)骨腫瘤提供了一種新的方法。
[Abstract]:Objective: to explore a new method of 3D printing prosthesis for large joint tumor of extremities. [methods] from January 2014 to May 2016, 6 patients with bone tumors of extremities were treated in our hospital. All the patients underwent CT scanning (1.0mm) before operation. The DICOM format data were obtained, the data were imported into Mimics 17.0 software, the three-dimensional model was edited, the osteotomy position was determined on the model, and the pore size, density and porosity of the implant, including titanium alloy prosthesis, were designed to match the remaining bone tissue. The new ligaments are more beautiful. The prognosis of the patients was evaluated by using the international skeletal muscle tumor limb salvage (MSTS) score system during follow-up. [results] all the patients were followed up for 4 ~ 25 months with an average of 13.2 months. X-ray examination showed that the residual bone tissue matched well with the tumor prosthesis, no loosening and osteolysis of the prosthesis, no recurrence or metastasis of the tumor. At the last follow-up, the MSTS score was 17 ~ 28, with an average of 25.7, of which 3 were excellent, 2 were good and 1 was fair. The excellent and good rate was 83.3%. [conclusion] through the application of 3D printing technology, the precise osteotomy range can be determined, the individualized joint prosthesis can be designed, the aperture, density and porosity of titanium alloy prosthesis can be adjusted, and the individualized ligament attachment point can be designed on the prosthesis. It provides a new method for the treatment of bone tumors in extremities.
【作者單位】： 北華大學附屬醫(yī)院骨外科二療區(qū);
【分類號】：R738;TP391.73

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