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用于掌骨巨细胞瘤切除术后骨缺损修复与重建的3D打印个性化假体。

3D-printed personalised prostheses for bone defect repair and reconstruction following resection of metacarpal giant cell tumours.

作者信息

Xu Lin, Qin Hao, Cheng Zhilin, Jiang Wen-Bo, Tan Jia, Luo Xiang, Huang Wenhua

机构信息

Department of Human Anatomy, School of Basic Medical Sciences, Guangxi Medical University, Nanning, China.

Guangxi Clinical Research Center for Digital Medicine and 3D Printing (Guigang City People's Hospital), Guigang, China.

出版信息

Ann Transl Med. 2021 Sep;9(18):1421. doi: 10.21037/atm-21-3400.

Abstract

BACKGROUND

Conventional surgical treatment for metacarpal giant cell tumours (GCTs) includes lesion scraping followed by bone grafting or bone cement filling and resection followed by repair and reconstruction using a vascularised bone flap. However, these methods have inherent shortcomings, including a high postoperative recurrence rate and poor mechanical stability. 3D-printing techniques are increasingly being applied in medicine, and 3D-printed personalised prostheses have achieved good clinical effects in orthopaedic repair and reconstruction. We aimed to investigate the clinical effects of 3D-printed personalised prostheses for bone defect repair and reconstruction following resection of metacarpal GCTs.

METHODS

Three patients with metacarpal GCTs were examined in a retrospective cohort study. Through preoperative planning, a 3D-printed personalised prosthesis was designed and created for bone defect repair and reconstruction after tumour resection. Prosthesis fit, limb function, pain on the affected side, and the occurrence of complications were evaluated postoperatively.

RESULTS

Postoperative X-ray examination revealed a satisfactory fit of the 3D-printed prosthesis in terms of bone defect size and overall metacarpal shape, as well as good transverse and longitudinal metacarpal arches. The patients also exhibited good function in the affected limb, with good flexion and extension functions in the carpal, metacarpophalangeal, and interphalangeal joints, plus the absence of obvious pain, tumour recurrence, and complications such as pathologic fractures and prosthetic loosening.

CONCLUSIONS

When using a 3D-printed personalised prosthesis for bone defect repair and reconstruction following resection of metacarpal GCTs, a good fit with the bone defect can be achieved during prosthetic installation when preoperative planning and design have been adequately performed. Therefore, three-dimensionally printed personalised prostheses can serve as an effective method for the treatment of metacarpal GCTs.

摘要

背景

掌骨巨细胞瘤(GCT)的传统手术治疗方法包括病灶刮除后植骨或骨水泥填充,以及切除后采用带血管蒂骨瓣进行修复重建。然而,这些方法存在固有缺陷,包括术后复发率高和机械稳定性差。3D打印技术在医学领域的应用日益广泛,3D打印个性化假体在骨科修复重建中取得了良好的临床效果。我们旨在探讨3D打印个性化假体用于掌骨GCT切除后骨缺损修复重建的临床效果。

方法

在一项回顾性队列研究中对3例掌骨GCT患者进行了检查。通过术前规划,设计并制作了3D打印个性化假体,用于肿瘤切除后骨缺损的修复重建。术后评估假体适配情况、肢体功能、患侧疼痛及并发症发生情况。

结果

术后X线检查显示,3D打印假体在骨缺损大小和掌骨整体形态方面适配良好,掌骨的横向和纵向弓形态良好。患者患侧肢体功能也良好,腕关节、掌指关节和指间关节屈伸功能良好,且无明显疼痛、肿瘤复发以及病理性骨折和假体松动等并发症。

结论

在掌骨GCT切除后使用3D打印个性化假体进行骨缺损修复重建时,若术前进行了充分的规划和设计,假体安装时可与骨缺损良好适配。因此,3D打印个性化假体可作为治疗掌骨GCT的有效方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2256/8506718/57193a1a869e/atm-09-18-1421-f1.jpg

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