传统与三维打印模型辅助手术治疗髋臼骨折的回顾性比较。
A retrospective comparison of the conventional versus three-dimensional printed model-assisted surgery in the treatment of acetabular fractures.
机构信息
Department of Orthopaedic Surgery, Ege University, School of Medicine, İzmir, Turkey.
Department of Anatomy Digital Imaging and 3D Modelling Laboratory, Ege University, School of Medicine, İzmir, Turkey.
出版信息
Acta Orthop Traumatol Turc. 2020 Jul;54(4):385-393. doi: 10.5152/j.aott.2020.19054.
OBJECTIVE
The aim of this study was to compare the clinical and radiological outcomes of the conventional versus individualized three-dimensional (3D) printing model-assisted pre-contoured plate fixation in the treatment of patients with acetabular fractures.
METHODS
The data from 18 consecutive patients who underwent surgery for the acetabular fractures were retrospectively analyzed. The patients were divided into two groups (9 in each): conventional and 3D printed model-assisted. The groups were then compared in terms of the duration of surgery, time of instrumentation, time of intraoperative fluoroscopy, and volume of blood loss. The quality of the fracture reduction was also evaluated postoperatively by radiography and computed tomography in both the groups. The quality of the fracture reduction was defined as good (<2 mm) or fair (>2 mm) based on the amount of displacement in the acetabulum.
RESULTS
The conventional group included 9 patients (9 males; mean age=41.7 years; age range=16-70) with a mean follow-up of 11.9 months (range=8-15); the 3D printed model-assisted group consisted of 9 patients (9 males; mean age=46.2 years; age range=30-66) with a mean follow-up of 10.33 months (range=7-17). The average duration of surgery, mean time of instrumentation, time of intraoperative fluoroscopy, and mean volume of blood loss were 180.5±9 minutes, 36.2±3.6 minutes, 6±1 times, and 403.3±52.7 mL in the 3D printed model-assisted group, and 220±15.6 minutes, 57.4±10.65 minutes, 10.4±2.2 times, and 606.6±52.7 mL in the conventional group, respectively. Procedurally, the average duration of surgery, mean time of instrumentation, and mean time of fluoroscopy were significantly shorter, and the mean volume of blood loss was significantly lower in the 3D printed model-assisted group (p<0.05). The quality of the fracture reduction was good in 7 patients (78%) in the conventional group and 8 patients (89%) in the 3D printed model-assisted group.
CONCLUSION
As compared with the conventional surgery, the 3D printing model-assisted pre-contoured plate fixation technique can improve the clinical and radiological outcomes of the acetabular fractures, with shorter surgery, instrumentation, intraoperative fluoroscopy times, and blood loss.
LEVEL OF EVIDENCE
Level III, Therapeutic study.
目的
本研究旨在比较常规与个体化三维（3D）打印模型辅助预成型钢板固定治疗髋臼骨折的临床和影像学结果。
方法
回顾性分析了 18 例接受髋臼骨折手术治疗的连续患者的数据。将患者分为两组（每组 9 例）：常规组和 3D 打印模型辅助组。然后比较两组手术时间、器械时间、术中透视时间和失血量。两组患者术后均行 X 线和 CT 评估骨折复位质量。根据髋臼移位量，将骨折复位质量定义为良好（<2mm）或一般（>2mm）。
结果
常规组 9 例患者（9 例男性；平均年龄 41.7 岁；年龄范围 16-70 岁），平均随访 11.9 个月（8-15 个月）；3D 打印模型辅助组 9 例患者（9 例男性；平均年龄 46.2 岁；年龄范围 30-66 岁），平均随访 10.33 个月（7-17 个月）。3D 打印模型辅助组的手术平均时间、器械平均时间、术中透视平均时间和平均失血量分别为 180.5±9 分钟、36.2±3.6 分钟、6±1 次和 403.3±52.7ml，常规组分别为 220±15.6 分钟、57.4±10.65 分钟、10.4±2.2 次和 606.6±52.7ml。手术过程中，3D 打印模型辅助组的手术时间、器械时间和透视时间平均明显缩短，失血量明显减少（p<0.05）。常规组骨折复位质量良好 7 例（78%），3D 打印模型辅助组 8 例（89%）。
结论
与常规手术相比，3D 打印模型辅助预成型钢板固定技术可改善髋臼骨折的临床和影像学结果，缩短手术、器械、术中透视时间和出血量。
证据水平
III 级，治疗研究。
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