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桡骨远端骨折 AO2R3 C 型的手术治疗的短期结果和并发症,通过使用 3D 打印模型进行规划。前瞻性随机对照研究。

Short-term results and complications of the operative treatment of the distal radius fracture AO2R3 C type, planned by using 3D-printed models. Prospective randomized control study.

机构信息

Clinic of Rheumatology, Orthopaedics Traumatology, and Reconstructive Surgery, Faculty of Medicine, Vilnius University, Vilnius, Lithuania.

出版信息

J Orthop Surg (Hong Kong). 2023 May-Aug;31(2):10225536231195127. doi: 10.1177/10225536231195127.

Abstract

PURPOSE

3D-printed models rapidly evolving in orthopaedic. Studies show that 3D-printed models used for preoperative planning improve a better understanding of fracture morphology and reduce operative time, blood loss and frequency of fluoroscopy, but there are no studies that investigated possible advantages in the outcomes and complications for the treatment of distal radius fracture (DRF). Our study aims to evaluate short-term functional results and complications between two groups treated DRF using 3D-printed models for preoperative planning and without. We hypothesize that the addition of 3D-printed models would improve functional outcomes and reduce complication rates.

METHODS

66 randomized cases of DRF AO/OTA C type were enrolled and divided into "Control group" ( = 33) and "3D-printed model group" ( = 33). Personalized 3D-printed models were created. The primary outcomes were: Patient-Rated Wrist Evaluation questionnaire, Quick Disabilities of the Arm, Shoulder and Hand Score questionnaire, and complications. The secondary outcomes were: measurement of the range of motions, grip strength, radiological evaluation, and the visual analogue scale. Assessments were measured at 6 weeks, 3 months, and 6 months intervals.

RESULTS

We found that the integration of the 3D-printed model in preoperative planning decreased complication incidence significantly - from 30.3% in the "Control group" to 6.1% in the "3D-printed model group", = .022. But we did not find a difference in functional and radiological outcomes.

CONCLUSION

The 3D-printed models for preoperative planning surgically treating DRF AO/OTA C type can help minimize the complication rate, however, they can't improve functional outcomes in the short-term results.

LEVEL OF EVIDENCE

Level I randomized controlled study.

摘要

目的

骨科中 3D 打印模型的快速发展。研究表明,用于术前规划的 3D 打印模型可提高对骨折形态的更好理解,并减少手术时间、失血量和透视频率,但尚无研究调查治疗桡骨远端骨折(DRF)时治疗结果和并发症方面的可能优势。我们的研究旨在评估使用和不使用 3D 打印模型进行术前规划治疗 DRF 的两组患者的短期功能结果和并发症。我们假设添加 3D 打印模型将改善功能结果并降低并发症发生率。

方法

共纳入 66 例 DRF AO/OTA C 型随机病例,并分为“对照组”(n=33)和“3D 打印模型组”(n=33)。创建个性化 3D 打印模型。主要结局指标为:患者腕关节评估问卷、快速上肢残疾问卷、手和肩残疾问卷以及并发症。次要结局指标为:运动范围、握力、影像学评估和视觉模拟评分的测量。在 6 周、3 个月和 6 个月的间隔进行评估。

结果

我们发现,在术前规划中整合 3D 打印模型可显著降低并发症发生率 - 从“对照组”的 30.3%降至“3D 打印模型组”的 6.1%,P=0.022。但我们没有发现功能和影像学结果的差异。

结论

术前规划治疗 DRF AO/OTA C 型的 3D 打印模型有助于降低并发症发生率,但不能改善短期结果的功能结果。

证据水平

I 级随机对照研究。

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