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数字化辅助中医手法整复联合3D打印夹板治疗AO型桡骨远端A型骨折的短期疗效

[Short-term efficacy of digitally-assisted traditional Chinese medicine manual reduction combined with 3D printed splint in the treatment of AO type-A distal radius fractures].

作者信息

Li Guo-Liang, Zhao Jian-Yong, Li Xiao-Ming, Wang Tie-Qiang, Chen Kang, Liu Qi-Lin

机构信息

Minimally Invasive Orthopedics Department, Cangzhou Integrated Traditional Chinese and Western Medicine Hospital, Cangzhou 061000, Hebei, China.

出版信息

Zhongguo Gu Shang. 2023 Sep 25;36(9):809-14. doi: 10.12200/j.issn.1003-0034.2023.09.004.

Abstract

Objective To explore the short-term efficacy of digitally-assisted traditional Chinese medicine manual reduction combined with 3D printed splint in the treatment of AO type-A distal radius fractures, and explore the quantification of traditional Chinese medicine manual reduction and personalized improvement of splinting. Methods The clinical data of 50 patients with AO type-A distal radius fractures, who received treatment at the outpatient department of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital in Hebei Province, were retrospective analyzed. The patient cohort included 22 females and 28 males, with ages ranging from 25 to 75 years old. Among them, 27 cases presented with distal radius fractures on the left side, and 24 cases on the right side. The patients were categorized into two groups: treatment group (=25) and control group(=25). There were 13 males and 12 females in the treatment group, with an average age of (56.2±5.5) years old. Treatment approach for this group involved several steps. Initially, Mimics Research software was used to conduct comprehensive analysis of complete CT data from the affected limb, resulting in the creation of a three-dimensional model. Subsequently, 3D models of the bones and skin contours, stored as STL format files, were imported into the Materialise Magics 23.0 software for model processing and repair. This facilitated the simulation of reduction and recording of displacement data, effectively generating a "digital prescription" to guide and quantify traditional Chinese medicine manipulation procedures. Finally, a personalized 3D printed splint was applied for fixation treatment. There were 15 males and 10 females in the control group, with an average age of (53.32±5.28) years old. These patients were treated with manualreduction combined with traditional splinting. The clinical efficacy of the two groups was assessed in terms of fracture reduction quality, fracture healing time, Gartland-Werley wrist joint score and X-ray parameters (palminclination angle, ulnar deviation angle, radius height) at 6 weeks post-operatively. Results The treatment group exhibited a shorter duration for achieving clinical healing compared to the control group (<0.05). Six weeks post-operatively, the treatment group demonstrated higher wrist joint function scores, and a higher proportion of excellent and good outcomes than the control group(<0.05). The treatment group was superior to the control group in terms of imaging parameters 6 weeks post-operatively (<0.05). Conclusion By quantifying skin contours through digital simulation prescription reduction, a personalized 3D printed splint is developed to effectively stabilize fractures, enhancing localized fixation while ensuring greater adherence, stability, and comfort. This innovative approach offers personalized treatment for AO type-A distal radius fractures and presents a novel, precise treatment strategy for consideration.

摘要

目的 探讨数字辅助中医手法整复联合3D打印夹板治疗AO-A型桡骨远端骨折的短期疗效,探索中医手法整复的量化及夹板的个性化改良。方法 回顾性分析河北省沧州市中西医结合医院门诊收治的50例AO-A型桡骨远端骨折患者的临床资料。患者队列包括22例女性和28例男性,年龄在25至75岁之间。其中,左侧桡骨远端骨折27例,右侧24例。将患者分为两组:治疗组(n=25)和对照组(n=25)。治疗组男性13例,女性12例,平均年龄(56.2±5.5)岁。该组治疗方法包括几个步骤。首先,使用Mimics Research软件对患侧肢体的完整CT数据进行综合分析,创建三维模型。随后,将存储为STL格式文件的骨骼和皮肤轮廓的3D模型导入Materialise Magics 23.0软件进行模型处理和修复。这有助于模拟整复并记录位移数据,有效生成“数字处方”以指导和量化中医手法操作程序。最后,应用个性化3D打印夹板进行固定治疗。对照组男性15例,女性10例,平均年龄(53.32±5.28)岁。这些患者采用手法整复联合传统夹板治疗。术后6周,根据骨折复位质量、骨折愈合时间、Gartland-Werley腕关节评分及X线参数(掌倾角、尺偏角、桡骨高度)评估两组的临床疗效。结果 治疗组临床愈合时间短于对照组(P<0.05)。术后6周,治疗组腕关节功能评分更高,优良率高于对照组(P<0.05)。术后6周,治疗组在影像学参数方面优于对照组(P<0.05)。结论 通过数字模拟处方整复量化皮肤轮廓,研制个性化3D打印夹板,有效稳定骨折,增强局部固定,同时确保更好的贴合性、稳定性和舒适性。这种创新方法为AO-A型桡骨远端骨折提供了个性化治疗,提出了一种新颖、精确的治疗策略供考虑。

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