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3D 打印辅助全髋关节置换术和内固定治疗新鲜髋臼骨折和股骨头坏死:一例报告。

3D printing-assisted total hip arthroplasty and internal fixation for the treatment of fresh acetabular fracture and femoral head necrosis: A case report.

机构信息

Department of Orthopedics Surgery, Central Hospital Affiliated to Shenyang Medical College, Shenyang, Liaoning, China.

出版信息

Medicine (Baltimore). 2023 Dec 29;102(52):e36832. doi: 10.1097/MD.0000000000036832.

Abstract

RATIONALE

Posterior wall comminuted fractures of the acetabulum are typically caused by high-energy trauma, and the complex anatomical structure of the acetabulum makes their treatment challenging. However, reports of the treatment of fresh acetabular fractures combined with femoral head necrosis are extremely rare.

PATIENT CONCERNS

A 57-year-old male, injured in a car accident, presented with right hip pain and limited mobility. At the age of 50, the patient was diagnosed with avascular necrosis of the right femoral head, experiencing right hip pain and a limp while walking, for which conservative treatment was initiated.

DIAGNOSIS

The patient was clinically diagnosed with fresh comminuted posterior wall acetabular fracture and late-stage femoral head necrosis.

INTERVENTIONS

We applied 3D printing technology and computer-assisted virtual surgical techniques for preoperative planning, simulated fracture reduction, and designed personalized bone plates and screws for fixation of the posterior wall of the acetabulum. A single-stage total hip arthroplasty was performed to treat femoral head necrosis.

OUTCOMES

He began walking with the assistance of a walker 1 month after surgery, and at 6 months post-surgery, the acetabular posterior wall fracture had effectively healed, allowing the patient to return to work.

LESSONS

The application of 3D printing technology in acetabular internal fixation and total hip arthroplasty is helpful for fracture assessment, facilitates smooth surgery, promotes fracture reduction and healing, restores hip joint function, and ensures a high level of safety.

摘要

背景

髋臼后壁粉碎性骨折通常由高能创伤引起,且髋臼复杂的解剖结构使其治疗具有挑战性。然而,关于新鲜髋臼骨折合并股骨头坏死治疗的报道极为罕见。

病例介绍

一名 57 岁男性,因车祸受伤,出现右髋部疼痛和活动受限。该患者在 50 岁时被诊断为右侧股骨头缺血性坏死,出现右髋部疼痛和行走时跛行,当时采用保守治疗。

临床诊断

患者被临床诊断为新鲜后壁粉碎性髋臼骨折和晚期股骨头坏死。

干预措施

我们应用 3D 打印技术和计算机辅助虚拟手术技术进行术前规划,模拟骨折复位,并设计了个性化的髋臼后壁接骨板和螺钉进行固定。同期行全髋关节置换术治疗股骨头坏死。

结果

术后 1 个月,患者在助行器的辅助下开始行走,术后 6 个月,髋臼后壁骨折有效愈合,患者可返回工作岗位。

结论

3D 打印技术在髋臼内固定和全髋关节置换术中的应用有助于骨折评估,有利于手术的顺利进行,促进骨折复位和愈合,恢复髋关节功能,并确保高度安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/01f6/10754600/24fe3b34805f/medi-102-e36832-g001.jpg

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