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基于3D打印的微创与传统切开钢板内固定治疗锁骨中段移位骨折的病例对照研究

[Case-control study on minimally invasive surgery and conventional open plating for displaced midshaft clavicular fracture based on 3D-print].

作者信息

You Jiong-Ming, Wu Yin-Sheng, Wang Yong

机构信息

Department of Orthopaedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University, Wenzhou 325000, Zhejiang, China.

Department of Orthopaedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Zhejiang Chinese Medical University, Wenzhou 325000, Zhejiang, China;

出版信息

Zhongguo Gu Shang. 2019 Jan 25;32(1):5-10. doi: 10.3969/j.issn.1003-0034.2019.01.002.

Abstract

OBJECTIVE

To compare clinical effect of minimally invasive surgery and conventional open plating for acute displaced midshaft clavicle fracture based on 3D-print.

METHODS

From July 2016 and December 2016, 40 patients with acute displaced midshaft clavicle fractures were retrospectively analyzed. The patients were divided into 3D minimally invasive surgery group (group A) and conventional open plating group (group B) according to different surgical incisions and whether to use 3D printing. In group A, including 11 males and 9 female, aged from 19 to 57 years old with an average of(37.2±9.3)years old; type 2A2 were 4 patients, type 2B1 were 9 patients and type 2B2 were 7 patients according to Robinson classification. In group B, including 13 males and 7 female, aged from 17 to 54 years old with an average of(35.1±9.5) years old; type 2A2 were 5 patients, type 2B1 were 8 patients and type 2B2 were 7 patients according to Robinson classification. Operative time, blood loss, length of incision, fracture healing time, complications were observed and compared between two groups, DASH score and Constant score of shoulder joint were evaluated at 12 months after operation.

RESULTS

Forty patients were followed up from 12 to 18 months with an average of(15.1±2.0) months. All fractures were healed, healing time in group A ranged from 12 to 18 months with an average of (14.3±1.7) months, in group B ranged from 11 to 18 months with an average of (14.4±1.9) months, while there was no statistical differences between two groups(>0.05). No differences in blood loss between two groups(>0.05). Operative time, length of incision in group A was less than that of group B (<0.05). There were no significant differences in DASH score and Constant score at 12 months between two groups(>0.05). One patient in group A occurred complication, and 6 patients in group B occurred compilations, and has statistical differences between two groups(<0.05).

CONCLUSIONS

Minimally invasive technique based on 3D-print could resolve some difficulties of minimally invasive surgery effectively and achieve fracture healing and functional recovery similar to traditional open reduction with more beautiful incision, less complication, shorter operation time.

摘要

目的

基于3D打印比较微创与传统切开钢板内固定治疗急性移位锁骨中段骨折的临床疗效。

方法

回顾性分析2016年7月至2016年12月收治的40例急性移位锁骨中段骨折患者。根据手术切口及是否使用3D打印分为3D打印辅助下微创手术组(A组)和传统切开钢板内固定组(B组)。A组男11例,女9例;年龄19~57岁,平均(37.2±9.3)岁;按Robinson分型:2A2型4例,2B1型9例,2B2型7例。B组男13例,女7例;年龄17~54岁,平均(35.1±9.5)岁;按Robinson分型:2A2型5例,2B1型8例,2B2型7例。观察比较两组手术时间、出血量、切口长度、骨折愈合时间、并发症情况,术后12个月采用DASH评分及肩关节Constant评分评估疗效。

结果

40例患者均获随访,随访时间12~18个月,平均((15.1±2.0)个月。所有骨折均愈合,A组骨折愈合时间12~18个月,平均(14.3±1.7)个月;B组骨折愈合时间11~18个月,平均(14.4±1.9)个月,两组比较差异无统计学意义(P>0.05)。两组术中出血量比较差异无统计学意义(P>0.05)。A组手术时间、切口长度均小于B组(P<0.05)。术后12个月两组DASH评分及Constant评分比较差异无统计学意义(P>0.05)。A组有1例患者出现并发症,B组有6例患者出现并发症,两组比较差异有统计学意义(P<0.05)。

结论

基于3D打印的微创技术能有效解决微创手术中的一些难点,骨折愈合及功能恢复与传统切开复位相似,且切口美观,并发症少,手术时间短。

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