Department of Pediatric Orthopaedics, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu, 210008, China.
Digital Medicine Institute, Nanjing Medical University, Nanjing, Jiangsu, 210006, China.
Sci Rep. 2017 Mar 21;7:44993. doi: 10.1038/srep44993.
To explore the feasibility of 3D-printed navigation template in proximal femoral varus rotation and shortening osteotomy for older children with developmental dysplasia of the hip (DDH). Between June 2014 and May 2015, navigation templates were designed and used for 12 DDH patients. Surgical information and outcomes were compared to 13 patients undergoing the same surgery but without navigation template. In template-guided patient group, operation time (21.08 min vs. 46.92 min), number of X-ray exposures (3.92 vs. 6.69), and occurrence of femoral epiphysis damage (0 vs. 0.92) were significantly decreased (P < 0.05). Furthermore, after 12-18 months follow-up, 66.7% and 16.7% of the hips in template-guided group were rated as excellent or good, respectively, according to the McKay criteria; 83.3% and 16.7% by using the Severin criteria respectively. By contrast, 46.2% and 23.1% of the hips in traditional operation group were classed as excellent or good, respectively, using the McKay criteria; 46.2% and 30.8% by using the Severin criteria respectively. The template-guided group achieved a better outcome; however, there was no significant difference. Application of the navigation template for older DDH children can reduce the operation time, radiation exposure, and epiphysis damage, which also simplifies surgery and improves precision.
为了探索 3D 打印导航模板在大龄发育性髋关节发育不良(DDH)儿童股骨近端内旋短缩截骨术中的可行性,我们在 2014 年 6 月至 2015 年 5 月期间设计并使用导航模板对 12 例 DDH 患者进行了手术。将手术信息和结果与 13 例接受相同手术但未使用导航模板的患者进行了比较。在模板引导组中,手术时间(21.08 分钟对 46.92 分钟)、X 射线曝光次数(3.92 次对 6.69 次)和股骨骨骺损伤的发生(0 对 0.92)显著减少(P<0.05)。此外,在 12-18 个月的随访中,根据 McKay 标准,模板引导组中有 66.7%和 16.7%的髋关节分别评为优秀或良好;根据 Severin 标准,分别有 83.3%和 16.7%的髋关节评为优秀或良好。相比之下,在传统手术组中,根据 McKay 标准,分别有 46.2%和 23.1%的髋关节评为优秀或良好;根据 Severin 标准,分别有 46.2%和 30.8%的髋关节评为优秀或良好。模板引导组的结果更好,但无显著差异。对于大龄 DDH 儿童,应用导航模板可以减少手术时间、辐射暴露和骨骺损伤,从而简化手术并提高精度。
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