实用医学杂志 ›› 2021, Vol. 37 ›› Issue (3): 353-357.doi: 10.3969/j.issn.1006⁃5725.2021.03.015

• 临床研究 • 上一篇    下一篇

3D打印联合关节镜微创治疗胫骨平台骨折

刘佩雷,张乐, 彭成, 陶奇昌, 代建昊, 常彬, 李强   

  1. 安徽理工大学第一附属医院(淮南市第一人民医院)(安徽淮南 232000)
  • 出版日期:2021-02-10 发布日期:2021-02-10
  • 通讯作者: 李强 E⁃mail:qiangli99@hotmail.com

Clinical study of 3D printing combined with arthroscopic minimally invasive treatment for tibial plateau fracture

LIU Peilei,ZHANG Le,PENG Cheng,TAO Qichang,DAI Jianhao,CHANG Bin,LI Qiang.
  

  1. The First Affiliated Hospital of Anhui University of Technology(Huainan first people′s Hospital),Huainan 232000,China
  • Online:2021-02-10 Published:2021-02-10
  • Contact: LI Qiang E⁃mail:qiangli99@hotmail.com

摘要:

目的 比较 3D 打印技术联合关节镜监视下复位术式与关节镜下监视治疗胫骨平台骨折的 疗效。方法 采用临床前瞻性对照研究的方法,2018年3月至2020年3月我院收治的胫骨平台骨折患者共 62例,采用随机数字法分为对照组和观察组各31例,对照组采用切开关节镜下监视复位植骨内固定,观察组在3D打印技术引导下经皮夹持、开小骨窗顶撬、关节镜监视复位微创的术式精准恢复胫骨平台的高度、 宽度及关节面的平整、复位植骨内固定,两组植骨材料及内固定均一致,手术均由同一主刀完成。比较两 组手术指标(包括平均手术时间、术中出血量、骨折复位时间)和临床指标(包括术后康复时间、疼痛和肿 胀程度、并发症),随访6个月比较膝关节功能(HSS)和运动功能(FMA)评分。结果 对照组共28例和观察 29 例完成随访,两组患者的一般临床资料具有可比性。观察组平均手术时间和骨折复位时间比对照组 缩短,术中出血量减少(P<0.05)。观察组术后 3 d 疼痛 VAS 评分比对照组降低,肿胀程度减轻(P<0.05); 两组术后康复时间和并发症发生率比较差异无统计学意义(P>0.05)。观察组随访 6 个月 HSS FMA 分均明显高于对照组(P<0.05)。结论 术前 3D 打印技术联合关节镜微创治疗胫骨平台骨折有较好的临床效果,能够缩短手术和骨折复位时间,减少出血量,降低术后疼痛和肿胀程度,改善膝关节功能和运 动功能。

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Abstract:

Objective To study the efficacy of 3D printing combined with arthroscopic reduction in the treatment of tibial plateau fractures with arthroscopic monitoring. Methods A total of 62 patients with tibial plateau fractures from March 2018 to March 2020 were selected and randomly divided into control group and obser⁃ vation group,31 cases in each group. The control group was treated with arthroscopy,and the observation group was given 3D printing before operation. The operation indicators including mean operation time,intraoperative blood loss,fracture reduction time and clinical indicators including postoperative recovery time,pain and swelling degrees,complications were compared between the two groups. The knee joint function(HSS)and motor function (FMA)scores were compared in the follow⁃up of 6 months. Results There were 28 patients in control group and 29 patients in observation group in all getting the follow⁃up. The mean operation time and fracture reduction time of observation group were shorter than those of control group,and intraoperative blood loss was less(P < 0.05). The VAS score in 3 days of observation group was lower than that in control group,and the degree of swelling was reduced(P < 0.05);while there were no differences of recovery time and complication rate between groups(P > 0.05). Lastly,the HSS and FMA scores of observation group were higher than those of control group after follow⁃up (P < 0.05). Conclusion 3D printing before operation assisting arthroscopic minimally invasive treatment for tibial plateau fracture has good clinical effect,which can shorten operation and fracture reduction time,reduce blood loss,lighten pain and swelling after operation,and improve knee joint function and motor function.

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