Miao Qiuju, Ding Huanwen, Huang Minqiang, Shen Jianjian, Tu Qiang, Huang Miaojun
Department of Bone and Joint Disease, Guangzhou General Hospital of Guangzhou Military, Guangzhou Guangdong, 510010, P.R.China;Graduate College, Traditional Chinese Medicine University of Guangzhou, Guangzhou Guangdong, 510010, P.R.China.
Department of Bone and Joint Disease, Guangzhou General Hospital of Guangzhou Military, Guangzhou Guangdong, 510010,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2017 Apr 15;31(4):385-391. doi: 10.7507/1002-1892.201611091.
To explore the clinical methods of resection of elbow tumor and total elbow replacement with custom personalized prosthesis based on three dimensional (3-D) printing navigation template.
In August 2016, a 63-year-old male patient with left elbow joint tumor was treated, with the discovery of the left distal humerus huge mass over 3 months, with elbow pain, activity limitation of admission. Computer-assisted reduction technique combined with 3-D printing was used to simulate preoperative tumor resection, a customized personal prosthesis was developed; tumor was accurately excised during operation, and the clinical result was evaluated after operation.
The time was 46 minutes for tumor resection, and was 95 minutes for personalized implant and allograft bone without fluoroscopy. X-ray and CT examination at 1 week after operation showed good position of artificial elbow joint; the anteversion of ulna prosthesis was 30° and the elbow carrying angle was 15°, which were consistent with the simulated results before surgery. The finger flexion was normal at 1 month after operation; the range of motion was 0-130° for elbow flexion and extension, 80° for forearm pronation, and 80° for forearm supination. The elbow function was able to meet the needs of daily life at 7 months after operation, and no recurrence and metastasis of tumor were observed.
For limb salvage of elbow joint, computer aided design can make preoperative surgical simulation; the navigation template can improve surgical precision; and the function of elbow joint can be reconstructed with customized and personlized prosthesis for total elbow replacement.
探讨基于三维(3-D)打印导航模板的肘关节肿瘤切除及定制个性化假体全肘关节置换的临床方法。
2016年8月,收治1例63岁左肘关节肿瘤男性患者,发现左肱骨远端巨大肿物3个多月,因肘关节疼痛、活动受限入院。采用计算机辅助复位技术联合3-D打印进行术前肿瘤切除模拟,定制个性化假体;术中准确切除肿瘤,术后评估临床效果。
肿瘤切除时间为46分钟,个性化植入物及同种异体骨植入时间为95分钟,无需透视。术后1周X线及CT检查显示人工肘关节位置良好;尺骨假体前倾角为30°,肘关节提携角为15°,与术前模拟结果一致。术后1个月手指屈曲正常;肘关节屈伸活动范围为0-130°,前臂旋前80°,前臂旋后80°。术后7个月肘关节功能可满足日常生活需要,未观察到肿瘤复发及转移。
对于肘关节保肢,计算机辅助设计可进行术前手术模拟;导航模板可提高手术精度;定制个性化假体进行全肘关节置换可重建肘关节功能。