Department of Orthopedic Surgery, The 908th Hospital of the Chinese People's Liberation Army Joint Logistics Support Forces, No.1028 Jinggangshan Avenue, Qingyunpu District, Nanchang, 330006, Jiangxi Province, People's Republic of China.
The First Clinical Medical College of Nanchang University, Nanchang, 330006, People's Republic of China.
J Orthop Surg Res. 2023 Jun 5;18(1):407. doi: 10.1186/s13018-023-03892-5.
3D printing techniques guide precision medicine and show great development potential in clinical applications. The purpose of this study was to compare the clinical outcomes of 3D-printed navigation templates versus free-hand in tension band wiring (TBW) procedures for olecranon fractures.
Patients who underwent TBW due to Mayo type II olecranon fractures between January 2019 and December 2021 in our hospital were prospectively enrolled in the study. The patients were divided into the 3D printed navigation template guiding TBW group (3D printed group) and the free-hand TBW group (free-hand group). The primary endpoint of this study was the success rate of the bicortical placement of Kirschner wires (K-wires). Times of intraoperative fluoroscopy, operation times, complications, VAS scores, and Mayo Elbow Performance Scores (MEPS) were analyzed as the secondary outcomes measure.
The success rate of the bicortical placement of K-wires was 85.7% in the 3D Printed group was significantly higher than the free-hand group (60%). There were fewer times of intraoperative fluoroscopy in the 3D Printed group (1.43 ± 0.51) than that in the free-hand group (2.60 ± 1.00) with statistical significance (P < 0.05). At the date of the last follow-up, four patients suffer from pain and skin injury at the K-wires insertion site in the 3D Printed group and 14 patients in the free-hand group, a significant difference between the two groups (P < 0.05). No statistically significant differences were found in operation time, VAS scores, and MEPS between the two groups.
The individualized 3D-printed navigation template-assisted TBW demonstrated good accuracy and resulted in reduced times of intraoperative fluoroscopy and complication compared to the free-hand TBW for olecranon fractures.
3D 打印技术指导精准医学,在临床应用中显示出巨大的发展潜力。本研究旨在比较 3D 打印导航模板与徒手在张力带钢丝固定(TBW)治疗尺骨鹰嘴骨折中的临床疗效。
前瞻性纳入 2019 年 1 月至 2021 年 12 月在我院接受 TBW 治疗的 Mayo Ⅱ型尺骨鹰嘴骨折患者。患者被分为 3D 打印导航模板引导 TBW 组(3D 打印组)和徒手 TBW 组(徒手组)。本研究的主要终点是克氏针(K 线)双皮质固定的成功率。分析术中透视次数、手术时间、并发症、视觉模拟评分(VAS)和 Mayo 肘功能评分(MEPS)作为次要观察指标。
3D 打印组 K 线双皮质固定成功率为 85.7%,明显高于徒手组(60%)。3D 打印组术中透视次数(1.43±0.51)明显少于徒手组(2.60±1.00),差异有统计学意义(P<0.05)。末次随访时,3D 打印组有 4 例患者在 K 线插入部位疼痛和皮肤损伤,徒手组有 14 例患者,两组差异有统计学意义(P<0.05)。两组手术时间、VAS 评分和 MEPS 无统计学差异。
与徒手 TBW 相比,个体化 3D 打印导航模板辅助 TBW 治疗尺骨鹰嘴骨折具有良好的准确性,可减少术中透视次数和并发症。