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使用3D打印模型进行股骨头复位截骨术的术前规划:两例报告

Preoperative planning of femoral head reduction osteotomy using 3D printing model: A report of two cases.

作者信息

Kalenderer Önder, Erkuş Serkan, Turgut Ali, İnan İrem Hazal

机构信息

Tepecik Training and Research Hospital, Department of Orthopaedics and Traumatology, İzmir, Turkey.

Tepecik Training and Research Hospital, Department of Orthopaedics and Traumatology, İzmir, Turkey.

出版信息

Acta Orthop Traumatol Turc. 2019 May;53(3):226-229. doi: 10.1016/j.aott.2019.01.002. Epub 2019 Jan 29.

Abstract

The deformed and enlarged femoral head secondary to hip diseases such as Legg Calve Perthes and Developmental Dysplasia usually causes impingement between the aspherical head and the acetabulum. To restore and reduce the size of enlarged femoral head, a femoral head reduction technique has been described previously. The goal is to obtain a spherical femoral head and to cover the gliding surface with best available cartilage. Planning of osteotomy to achieve spherical head is the crucial point of surgery. It is usually done intra-operatively and dependent on experience of surgeon. Preoperative 3- Dimension (D) modeling of femoral head is commonly preferred to minimize this risk. In this technical note, preoperative planning with 3-D printing was demonstrated in two separate patients with Legg-Calve-Perthes Disease and developmental hip dysplasia. Surgical time was approximately 150 and 120 min, respectively. Blood loss was 230 and 300 cc, respectively. Patients were followed up 9 months and 12 months, respectively. None of the patients in this study developed avascular necrosis; however, the follow-up period is very limited. Moreover, none of the patients developed post-operative complications or required additional surgery. With a more detailed preoperative planning done on computer model and printed in 3-D, one can mimic the surgical procedure before the procedure. Finally, this technique is advantageous both for the patient and surgeon.

摘要

继发于诸如Legg-Calve-Perthes病和发育性髋关节发育不良等髋关节疾病的股骨头变形和增大,通常会导致非球形股骨头与髋臼之间发生撞击。为了恢复并减小增大的股骨头的尺寸,之前已经描述了一种股骨头复位技术。目标是获得一个球形股骨头,并用现有的最佳软骨覆盖滑动表面。规划截骨术以实现球形头是手术的关键点。这通常在手术中完成,并且取决于外科医生的经验。通常更倾向于进行术前股骨头三维(3-D)建模,以将这种风险降至最低。在本技术说明中,对两名分别患有Legg-Calve-Perthes病和发育性髋关节发育不良的患者进行了3-D打印术前规划的演示。手术时间分别约为150分钟和120分钟。失血量分别为230毫升和300毫升。患者分别接受了9个月和12个月的随访。本研究中的患者均未发生缺血性坏死;然而,随访期非常有限。此外,患者均未出现术后并发症或需要额外手术。通过在计算机模型上进行更详细的术前规划并进行3-D打印,可以在手术前模拟手术过程。最后,该技术对患者和外科医生都有利。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3892/6599387/b2516642902f/gr1.jpg

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