Yang Zhanyu, Sheng Bin, Liu Delong, Wang Yiwei, Liu Chao, Xiao Rui
Department of Orthopedics, Hunan Provincial People's Hospital (the First Affiliated Hospital of Hunan Normal University), Changsha, China.
Department of Orthopedics, Hunan Emergency Center, Changsha, China.
Front Surg. 2023 Jan 6;9:1025650. doi: 10.3389/fsurg.2022.1025650. eCollection 2022.
Pelvic injuries refer to the disruption of the inherent structural and mechanical integrity of the pelvic ring. Sacroiliac screw fixation technique is often used for the treatment of posterior pelvic ring injury, which is prone to the iatrogenic injury. Various attempts were proposed to avoid iatrogenic injuries, while the executing processes are usually too cumbersome. The patient-personalized guide template based on 3D printing technology has been considered as a promising method, which can achieve lower deviation and higher accuracy in a simple and convenient way. We reported the first case of posterior pelvic ring injury using 3D printing personalized guide template with the verification of intraoperative CT.
The subject was a 74-year-old female with posterior pelvic ring injury. Two patient-specific guide templates were customized based on 3D printing technology, one for S1 and the other for S2. We used the guide templates for navigation to place the sacroiliac screws. The placement of screws was verified by intraoperative CT. Intraoperative and postoperative variables were collected.
The technique helped us successfully insert the sacroiliac screws into the safe zone. The intraoperative blood loss was 23.03 ml, and the duration of operation was 62 min. The exposure dose during CT scanning was 7.025 mSv. The assessment of screws position was excellent. Furthermore, there was no sign of any functional impairment postoperatively.
Sacroiliac screws fixation with the assistance of 3D printing personalized guide template under the verification of intraoperative CT may be a promising method to treat posterior pelvic ring injuries.
骨盆损伤是指骨盆环固有结构和力学完整性的破坏。骶髂螺钉固定技术常用于治疗骨盆后环损伤，该技术容易导致医源性损伤。人们提出了各种避免医源性损伤的方法，但执行过程通常过于繁琐。基于3D打印技术的患者个性化导向模板被认为是一种很有前景的方法，它可以以简单方便的方式实现更低的偏差和更高的准确性。我们报告了首例使用3D打印个性化导向模板并经术中CT验证治疗骨盆后环损伤的病例。
研究对象为一名74岁的骨盆后环损伤女性。基于3D打印技术定制了两个患者特异性导向模板，一个用于S1，另一个用于S2。我们使用导向模板进行导航以置入骶髂螺钉。通过术中CT验证螺钉的置入情况。收集术中及术后变量。
该技术帮助我们成功地将骶髂螺钉置入安全区域。术中出血量为23.03 ml，手术时间为62 min。CT扫描期间的暴露剂量为7.025 mSv。螺钉位置评估良好。此外，术后没有任何功能障碍的迹象。
在术中CT验证下，借助3D打印个性化导向模板进行骶髂螺钉固定可能是治疗骨盆后环损伤的一种有前景的方法。
