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3D打印定制植入物用于40例眼眶壁骨折修复的疗效

Efficacy of 3D-printed patient specific implant for orbital wall fracture repair in a series of 40 patients.

作者信息

Yang Min Kyu, Ha Seong Jung, Kim Gye Jung, Ock Junhyeok, Kim Namkug, Sa Ho-Seok

机构信息

Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Department of Ophthalmology, Myongji Hospital, Gyeonggi-do, Republic of Korea.

出版信息

Sci Rep. 2025 Feb 3;15(1):4087. doi: 10.1038/s41598-024-84166-w.

Abstract

This study was aimed to evaluate the efficacy of a 3D-printed patient specific implant (PSI) made of polycaprolactone (PCL) in repairing orbital wall fractures. We retrospectively reviewed patients who underwent surgical repair for unilateral orbital wall fractures using a 3D-printed PCL PSI. Computed tomography scans were used to compare the orbital tissue volumes and the morphological similarity (root-mean-square [RMS] conformance distance) between the fractured wall and the mirrored counterpart before and after surgery. All orbital fractures (inferior wall, 19; medial wall, 9; and combined inferior and medial walls, 12) were successfully repaired without postoperative complications. The mean time for implant insertion during surgery was 19.8 s (range, 3-60). The mean orbital tissue volume ratio between the fractured orbit and the contralateral normal orbit significantly decreased after surgery (109.0% preoperatively vs. 100.6% at postoperative 6 months, P < 0.001, paired t-test). The median RMS conformance distance significantly decreased after surgery (3.426 mm preoperatively vs. 1.073 mm at postoperative 6 months, P < 0.001, Wilcoxon signed-rank test). Our findings suggest that using a 3D-printed PCL PSI could effectively restore the original volume and shape of the orbit, thus being a valuable addition to the surgeon's armamentarium for managing orbital wall fractures.

摘要

本研究旨在评估由聚己内酯(PCL)制成的3D打印患者特异性植入物(PSI)修复眶壁骨折的疗效。我们回顾性分析了使用3D打印PCL PSI进行单侧眶壁骨折手术修复的患者。采用计算机断层扫描来比较手术前后骨折壁与镜像对应物之间的眼眶组织体积和形态相似性(均方根[RMS]符合距离)。所有眶壁骨折(下壁19例、内侧壁9例、下壁和内侧壁联合骨折12例)均成功修复,无术后并发症。手术中植入物插入的平均时间为19.8秒(范围3 - 60秒)。骨折眼眶与对侧正常眼眶之间的平均眼眶组织体积比在术后显著降低(术前为109.0%,术后6个月为100.6%,P < 0.001,配对t检验)。术后均方根符合距离中位数显著降低(术前为3.426毫米,术后6个月为1.073毫米,P < 0.001,Wilcoxon符号秩检验)。我们的研究结果表明,使用3D打印PCL PSI可有效恢复眼眶的原始体积和形状,因此是外科医生处理眶壁骨折的有用补充手段。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5662/11791147/5974d4c2a61f/41598_2024_84166_Fig1_HTML.jpg

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