Chen Chunhui, Cai Leyi, Zheng Wenhao, Wang Jianshun, Guo Xiaoshan, Chen Hua
Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109 Xue Yuan Xi Road, Wenzhou, 325000, Zhejiang, China.
BMC Musculoskelet Disord. 2019 Feb 8;20(1):65. doi: 10.1186/s12891-019-2448-9.
The aim of this study was to evaluate the efficacy of the use of three-dimensional (3D) printing models for preoperative planning in cases of complex fracture.
In total, 48 patients with AO type C fractures of the distal radius were enrolled in the study between January 2014 and January 2015. They were divided randomly into 3D model (n = 23) and routine treatment (n = 25) groups. A 3D digital model of each distal radius fracture in the former group was constructed. The model was exported to a 3D printer for construction of a full solid model. During each operation, the operative time, amount of blood loss, and frequency of intraoperative fluoroscopy were recorded, which were regarded as primary outcome measures. Patients were followed to evaluate surgical outcomes by Gartland-Werley scores, radiological evaluation, and range of motion of wrist, and these were regarded as the secondary outcome measures. In addition, we invited surgeons and patients to complete questionnaires.
The treatment of complex fractures using the 3D printing approach reduced the frequency of intraoperative fluoroscopy, blood loss volume, and operative time, but did not improve postoperative function compared with routine treatment. The patients wanted the doctor to use the 3D model to describe the condition and introduce the operative plan because it facilitated their understanding. The orthopaedic surgeons thought that the 3D model was useful for communication with patients, but were much less satisfied with its use in preoperative planning.
Our study revealed that 3D printing models effectively help the doctors plan and perform the operation and provide more effective communication between doctors and patients, but can not improve postoperative function compared with routine treatment.
This trial was registered at the Chinese Clinical Trial Registry on May 9, 2017 (ChiCTR-IRP-17011343, http://www.chictr.org.cn/showproj.aspx?proj=19264 ).
本研究旨在评估三维(3D)打印模型在复杂骨折病例术前规划中的应用效果。
2014年1月至2015年1月,共纳入48例桡骨远端AO C型骨折患者。他们被随机分为3D模型组(n = 23)和常规治疗组(n = 25)。前一组中每个桡骨远端骨折均构建了3D数字模型。该模型被导出至3D打印机以构建全实体模型。每次手术期间,记录手术时间、失血量及术中透视频率,将其视为主要结局指标。对患者进行随访,通过Gartland-Werley评分、影像学评估及腕关节活动度评估手术效果,将这些视为次要结局指标。此外,我们邀请外科医生和患者完成问卷。
与常规治疗相比,采用3D打印方法治疗复杂骨折可降低术中透视频率、减少失血量及缩短手术时间,但术后功能并未改善。患者希望医生使用3D模型描述病情并介绍手术方案,因为这有助于他们理解。骨科医生认为3D模型有助于与患者沟通,但对其在术前规划中的应用满意度较低。
我们的研究表明,3D打印模型能有效帮助医生规划和实施手术,并在医生与患者之间提供更有效的沟通,但与常规治疗相比并不能改善术后功能。
本试验于2017年5月9日在中国临床试验注册中心注册(ChiCTR-IRP-17011343,http://www.chictr.org.cn/showproj.aspx?proj=19264 )。