Zheng Peng-Fei, Chen Jie, Xux Xu Peng, Jiang Bo, Yao Qing-Qiang, Wang Li-Ming
Department of Orthopaedic Surgery, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu, China;
Zhongguo Gu Shang. 2017 Apr 25;30(4):377-382. doi: 10.3969/j.issn.1003-0034.2017.04.020.
To investigate the feasibility and accuracy of a new navigation template for osteotomy in cubitus varus based on computer assistant design and 3D printing technology.
The preoperative CT images of 15 children with cubitus varus from June 2015 to June 2016 were collected. According to the above data, the individual osteotomy navigate template match the distal humerus was designed by the software and printed by the 3D printer. Accurate osteotomy was performed with the assistant of the navigate template in the operation. Internal fixation of the osteotomy site was performed with 2 Kirschner wires. After surgery, a long arm plaster was applied with 20° of elbow flexion. All the patients underwent radiographic and clinical evaluations before surgery and at the follow-up examination.
During the operation, the navigate template with the individual design of 3D printing technology matched the bony markers of distal humerus. Accurate and simple osteotomy were performed along the resected surface of the navigation template. None of the cases required any kinds of revision surgery or had any complaint of cosmetic appearance. Average union time was 6.7 weeks(ranged, 6 to 8 weeks). Twelve patients got an excellent result and 2 got a good result according to the criteria described by Bellemore. There were no cases with complications of infection or ulnar nerve palsy or joint stiffness.
With the help of 3D printing technology, the accurate osteotomy in cubitus varus assisted by individualized navigate template can be realized. This technology can restore normal anatomical structure of the elbow joint to the greatest extent. It is worthy of popularization and application.
探讨基于计算机辅助设计和3D打印技术的新型肘内翻截骨导航模板的可行性及准确性。
收集2015年6月至2016年6月15例肘内翻患儿的术前CT图像。根据上述数据，通过软件设计与肱骨远端匹配的个体化截骨导航模板，并由3D打印机打印。术中在导航模板辅助下进行精确截骨。截骨部位用2根克氏针进行内固定。术后应用长臂石膏，肘关节屈曲20°。所有患者在术前及随访检查时均进行影像学和临床评估。
术中，采用3D打印技术个体化设计的导航模板与肱骨远端的骨性标志相匹配。沿导航模板的截骨面进行了精确且简单的截骨。所有病例均无需任何翻修手术，也无任何外观方面的主诉。平均愈合时间为6.7周（范围6至8周）。根据Bellemore描述的标准，12例患者结果为优，2例为良。无感染、尺神经麻痹或关节僵硬等并发症病例。
借助3D打印技术，可实现个体化导航模板辅助下肘内翻的精确截骨。该技术能最大程度恢复肘关节的正常解剖结构。值得推广应用。
