Kim Young Chul, Jeong Woo Shik, Park Tae-Kyung, Choi Jong Woo, Koh Kyung S, Oh Tae Suk
Department of Plastic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Emergency, The Newcastle Upon Tyne Hospitals, Newcastle Upon Tyne, United Kingdom.
J Craniomaxillofac Surg. 2017 Jun;45(6):928-936. doi: 10.1016/j.jcms.2017.03.010. Epub 2017 Mar 27.
This study evaluated the accuracy of blow out fracture reduction using 3D-printed rapid prototyping (RP) skull modeling.
Retrospective review was performed for 82 patients who underwent post-traumatic orbital wall fracture reduction between 2012 and 2014. Patients were divided into two groups according to the use of 3D-printed RP skull model reproduced by mirroring technique, onto which a titanium mesh was anatomically molded. Using computed tomographic scans, the areas of pre- and post-operative orbital wall defect, the layout angles of the titanium mesh, and the gap lengths between the implant and fracture margin were compared between the two groups.
Of the 82 patients identified, 46 and 36 were diagnosed with medial and inferior orbital wall fractures, respectively. Bone defect area of the RP group was significantly reduced in comparison with that of the conventional group (8.03 ± 3.5% versus 18.7 ± 15.41% for medial wall fractures, 7.14 ± 5.74% versus 12.8 ± 4.92% for inferior wall fractures, respectively, p < 0.01). Satisfactory results were achieved regarding the layout angles and the gap lengths, presenting significantly reduced values in the RP group compared to that in the conventional group (p < 0.01).
More accurate restoration of traumatic orbital wall fractures can be achieved using patient-specific 3D-printed RP skull models.
本研究评估了使用3D打印快速成型（RP）颅骨模型进行爆裂性骨折复位的准确性。
对2012年至2014年间接受创伤后眶壁骨折复位的82例患者进行回顾性研究。根据是否使用通过镜像技术复制的3D打印RP颅骨模型将患者分为两组，在该模型上按解剖结构塑形钛网。利用计算机断层扫描，比较两组患者术前和术后眶壁缺损面积、钛网的布局角度以及植入物与骨折边缘之间的间隙长度。
在确定的82例患者中，分别有46例和36例被诊断为眶内侧壁骨折和眶下壁骨折。与传统组相比，RP组的骨缺损面积显著减小（眶内侧壁骨折分别为8.03±3.5% 对18.7±15.41%，眶下壁骨折分别为7.14±5.74% 对12.8±4.92%，p<0.01）。在布局角度和间隙长度方面取得了满意的结果，与传统组相比，RP组的值显著降低（p<0.01）。
使用患者特异性的3D打印RP颅骨模型可以更准确地修复创伤性眶壁骨折。
