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3D 打印股骨近端良性肿瘤开窗及螺钉钻孔多功能导向板

3D-printed Multifunctional Guide Plate for Fenestration and Screws Drill in Proximal Femoral Benign Tumor.

机构信息

Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, China.

Montefiore Medical Center, Albert Einstein School of Medicine, New York, New York, USA.

出版信息

Orthop Surg. 2024 Jun;16(6):1487-1492. doi: 10.1111/os.14075. Epub 2024 May 10.

Abstract

The accurate fenestration, screw implantation and assisting stabilizing-plate placement in surgery of benign tumors in the proximal femur needs be defined easily. The aim of this study was to investigate the value of 3D printed multifunctional guides plate (3D-MGP) based on computer aided design. Between January 2020 and June 2022, 17 patients (nine females and eight males) with benign proximal femoral tumor had lesion curettage and allograft combined with internal plate fixation using 3D-MGP. In this study, the patients had CT scans and a technician reconstructed the 3D images of tumor and the femur, a doctor designed the location and margin of the fenestration and screws, and integrated different functions into MGP for benign proximal femoral lesions, which assisted in precise localization, fenestration and screw drilling. Musculoskeletal Tumor Society (MSTS) scoring was used to evaluate lower extremity function. Bone healing and the screws location was assessed with the radiographs. All patients underwent successful surgery with complete resection of the tumor and internal fixation with using the 3D-MGP. The mean follow-up was 16.4 months. The operative time was 126.47 ± 18.44 min, intraoperative bleeding was 198.23 ± 67.94 mL, intraoperative fluoroscopy was 6.47 ± 0.62, postoperative drainage was 223.82 ± 119.51 mL, and MSTS score was 27.29 ± 1.31 points. There were no unplanned fenestration and improper screw fixation. The 3D-MGP enabled personalized and accurate location of tumor, fenestration, screw placement and assisted stabilizing-plate placement for the treatment of benign tumor of the proximal femur. This technique has the potential to shorten operative times, decrease intraoperative bleeding, and reduce radiation exposure to patients.

摘要

在股骨近端良性肿瘤的手术中,需要精确地开窗、植入螺钉和辅助放置稳定钢板。本研究旨在探讨基于计算机辅助设计的 3D 打印多功能导板(3D-MGP)的价值。2020 年 1 月至 2022 年 6 月,17 例股骨近端良性肿瘤患者采用 3D-MGP 行病灶刮除+同种异体骨植骨+内固定板固定。本研究中,患者行 CT 扫描,技术员重建肿瘤和股骨的 3D 图像,医生设计开窗和螺钉的位置和边缘,并将不同功能集成到 MGP 中,用于治疗股骨近端良性病变,以协助精确定位、开窗和螺钉钻孔。采用肌肉骨骼肿瘤学会(MSTS)评分评估下肢功能。通过 X 线片评估骨愈合和螺钉位置。所有患者均成功完成手术,肿瘤完全切除,采用 3D-MGP 进行内固定。平均随访 16.4 个月。手术时间为 126.47±18.44min,术中出血量为 198.23±67.94mL,术中透视次数为 6.47±0.62 次,术后引流为 223.82±119.51mL,MSTS 评分为 27.29±1.31 分。无计划开窗和螺钉固定不当。3D-MGP 可实现肿瘤、开窗、螺钉放置和辅助稳定钢板放置的个体化和精确定位,用于治疗股骨近端良性肿瘤。该技术有可能缩短手术时间、减少术中出血并降低患者的辐射暴露。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ada1/11144502/915a662b1f77/OS-16-1487-g003.jpg

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