3D 打印截骨导板在儿童发育性髋关节脱位股骨近端截骨术中的应用:一项回顾性研究。
Application of 3D-printed osteotomy guide plates in proximal femoral osteotomy for DDH in children: a retrospective study.
机构信息
Department of Orthopaedic Surgery, The Fourth Affiliated Hospital of Harbin Medical University, No. 37, Yiyuan Street, Nangang District, Harbin City, 150001, Heilongjiang Province, China.
出版信息
J Orthop Surg Res. 2023 Apr 24;18(1):315. doi: 10.1186/s13018-023-03801-w.
BACKGROUND
Patients with developmental dysplasia of the hip (DDH) have complex proximal femoral deformities, and orthopedic surgery lacks objectivity. Expectations for surgical outcomes are often not achieved, and postoperative problems are common. Using 3D-printed technology in orthopedics offers a novel approach to precise and individualized treatment in modern orthopedics. The aim of this study was to investigate the value of the application of 3D-printed osteotomy guide plates in femoral osteotomy. The clinical indices of femoral osteotomy in children with DDH using 3D-printed osteotomy guide plates were compared with those of traditional osteotomy.
METHODS
The clinical data of children with DDH who underwent open reduction and Salter pelvic osteotomy combined with femoral osteotomy from September 2010 to September 2020 were retrospectively collected and analyzed. Based on the inclusion and exclusion criteria, a total of 36 patients were included in the study: 16 in the guide plate group and 20 in the conventional group. Operation time (total), operation time (femoral side), X-ray fluoroscopy times (total), X-ray fluoroscopy times (femoral side) and intraoperative blood loss were analyzed and compared between the two groups. Comparison of treatment-related indicators such as postoperative neck-shaft angle, postoperative anteversion angle, hospitalization time, and hospitalization expenses is made between the two groups. The two groups of patients were evaluated at the last follow-up using the McKay clinical evaluation criteria.
RESULTS
Between the two groups, there were significant differences in operation time (total), operation time (femoral side), X-ray fluoroscopy times (total), X-ray fluoroscopy times (femoral side) and intraoperative blood loss (P < 0.05). The postoperative neck-shaft angle, postoperative anteversion angle, hospitalization time and hospitalization expenses did not differ significantly (P > 0.05). The MacKay clinical evaluation did not significantly differ at the most recent follow-up (P > 0.05).
CONCLUSIONS
Children with DDH undergoing proximal femoral osteotomy using 3D-printed osteotomy guide plates benefit from a simpler surgical procedure, shorter operative time, less bleeding and less radiation exposure during surgery. This technique is of great clinical value.
背景
发育性髋关节发育不良(DDH)患者的股骨近端存在复杂的畸形,而矫形外科缺乏客观性。手术结果的预期往往无法实现,术后问题也很常见。3D 打印技术在矫形外科中的应用为现代矫形提供了一种精确和个体化治疗的新方法。本研究旨在探讨 3D 打印截骨导板在股骨截骨中的应用价值。比较了 3D 打印截骨导板组与传统截骨组儿童 DDH 股骨截骨的临床指标。
方法
回顾性收集并分析了 2010 年 9 月至 2020 年 9 月接受切开复位+Salter 骨盆截骨+股骨截骨的 DDH 患儿的临床资料。根据纳入和排除标准,共纳入 36 例患者:导板组 16 例,常规组 20 例。分析比较两组患者手术时间(总)、手术时间(股骨侧)、X 线透视次数(总)、X 线透视次数(股骨侧)和术中出血量。比较两组患者术后颈干角、术后前倾角、住院时间、住院费用等治疗相关指标。两组患者末次随访均采用 McKay 临床评价标准进行评价。
结果
两组患者的手术时间(总)、手术时间(股骨侧)、X 线透视次数(总)、X 线透视次数(股骨侧)和术中出血量差异有统计学意义(P < 0.05)。术后颈干角、术后前倾角、住院时间和住院费用差异无统计学意义(P > 0.05)。末次随访时 McKay 临床评价差异无统计学意义(P > 0.05)。
结论
3D 打印截骨导板辅助儿童近端股骨截骨术可简化手术过程,缩短手术时间,减少术中出血和辐射暴露。该技术具有重要的临床价值。
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