Department of Orthopedics, Xiangya Hospital, Central South University, No. 87 Xiangya Road, Changsha 410008, China.
Department of Orthopedics, Qingdao Chengyang Guzhen Orthopedic Hospital, No. 518 Yinhe Road, Chengyang District, Qingdao 266107, China.
Biomed Res Int. 2021 Jun 10;2021:1308805. doi: 10.1155/2021/1308805. eCollection 2021.
The aim of this study was to investigate the application of computer-aided design and 3D printing technology for percutaneous fixation of femoral neck fractures using cannulated compression screws.
Using computed tomography data, an individualized proximal femur model was created with a 3D printer. The reduction of the femoral neck fracture and the placement of the cannulated compression screws were simulated on a computer. A 3D printing guide plate was designed to match the proximal femur. After demonstrating the feasibility of the 3D model before the surgical procedure, the guide needles and cannulated compression screws were inserted with the aid of the 3D-printed guide plate.
During the procedure, the 3D-printed guide plate for each patient matched the bone markers of the proximal femur. With the aid of the 3D-printed guide plate, three cannulated compression screws were accurately inserted into the femoral neck to treat femoral neck fractures. After screw placement, intraoperative X-ray examination showed results that were consistent with the preoperative design. The time taken to complete the procedure in the guide plate group was 35.3 ± 2.1 min, the intraoperative blood loss was 6.3 ± 2.8 mL, and X-ray fluoroscopy was only performed 9.1 ± 3.5 times. Postoperative radiographs showed adequate reduction of the femoral neck fractures. The entry point, entry direction, and length of the three cannulated compression screws were consistent with the preoperative design, and the screws did not penetrate the bone cortex.
Using computer-aided design and 3D printing technology, personalized and accurate placement of cannulated compression screws can be realized for the treatment of femoral neck fractures. This technique can shorten the time required for the procedure and reduce damage to the femoral neck cortex, intraoperative bleeding, and the exposure of patients and healthcare staff to radiation.
本研究旨在探讨计算机辅助设计和 3D 打印技术在经皮股骨颈骨折空心加压螺钉固定中的应用。
使用计算机断层扫描数据，通过 3D 打印机创建个体化的股骨近端模型。在计算机上模拟股骨颈骨折的复位和空心加压螺钉的放置。设计与股骨近端匹配的 3D 打印导板。在手术前演示 3D 模型的可行性后，在 3D 打印导板的辅助下插入导针和空心加压螺钉。
在手术过程中，每位患者的 3D 打印导板均与股骨近端的骨标记匹配。借助 3D 打印导板，准确地将三根空心加压螺钉插入股骨颈以治疗股骨颈骨折。螺钉放置后，术中 X 线检查结果与术前设计一致。导板组完成手术的时间为 35.3±2.1 分钟，术中出血量为 6.3±2.8 毫升，X 线透视仅进行 9.1±3.5 次。术后 X 线片显示股骨颈骨折复位良好。三根空心加压螺钉的进钉点、进钉方向和长度均与术前设计一致，且螺钉未穿透骨皮质。
应用计算机辅助设计和 3D 打印技术，可实现股骨颈骨折空心加压螺钉的个体化、精准置入。该技术可缩短手术时间，减少对股骨颈皮质、术中出血以及患者和医护人员辐射暴露的损伤。
