摘要
目的探讨3D打印技术计算机辅助下虚拟手术模拟在髋臼骨折术前规划中应用的可行性和有效性。方法回顾性分析2013年9月~2015年12月行手术治疗并获完整随访的53例髋臼患者资料。其中19例患者应用CT三维重建、计算机虚拟复位内固定、3D模型打印、个性化手术模拟,术中按术前规划手术(3D组);34例患者行术前常规检查,术中经验性手术(常规组)。记录两组患者的术中出血量、围手术期输血量、术中透视次数、手术时间、骨折复位质量等。并应用MIMICS软件的三维叠加功能将术前规划与术后结果进行比较分析。结果所有患者均顺利完成手术,3D组术中出血量、围手术期输血量、术中透视次数少,手术时间缩短,以上项目两组间比较差异均有统计学意义(P<0.05)。术后根据Matta评分标准评定骨折复位质量:3D组与常规组优良率分别为[94.7%(18/19)∶82.4%(28/34)];末次随访时髋关节功能根据改良Merle D’Aubigne&Postel评分标准:优良率分别为[89.5%(17/19)∶85.3%(29/34)],以上项目两组间比较差异均无统计学意义(P>0.05);3D组术前术后CT数据MIMICS软件三维叠加显示实际内固定放置与术前设计吻合度较高。结论 3D打印技术计算机辅助下虚拟手术对髋臼骨折进行术前规划是可行的、精确的,能有效提高手术效率。
Objective To evaluate the feasibility and effectiveness of using 3D printing and computer-assisted surgical simulation in preoperative planning for acetabular fractures. Methods A retrospective analysis was performed in 53 patients with pelvic fracture,who underwent surgical treatment between September,2013 and December,2015 with complete followup data. Among them,19 patients were treated with CT three-dimensional reconstruction,computer-assisted virtual reset internal fixation,3D model printing,and personalized surgery simulation before surgery(3D group),and 34 patients underwent routine preoperative examination(conventional group). The intraoperative blood loss,transfusion volume,times of intraoperative X-ray,operation time,Matta score and Merle D' Aubigne & Postel score were recorded in the 2 groups.Preoperative planning and postoperative outcomes in the two groups were compared. Results All the operations were completed successfully. In 3D group,significantly less intraoperative blood loss,transfusion volume,fewer times of X-ray,and shortened operation time were recorded compared with those in the conventional group(P<0.05). According to the Matta scores,excellent or good fracture reduction was achieved in 94.7%(18/19) of the patients in 3D group and in 82.4%(28/34) of the patients in conventional group; the rates of excellent and good hip function at the final follow-up were 89.5%(17/19) in the 3D group and 85.3%(29/34) in the conventional group(P>0.05). In the 3D group,the actual internal fixation well matched the preoperative design. Conclusions 3D printing and computer-assisted surgical simulation for preoperative planning is feasible and accurate for management of acetabular fracture and can effectively improve the operation efficiency.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2017年第3期378-382,共5页
Journal of Southern Medical University
基金
广东省科技计划项目(2014A020212176
2014B090901055
2016B090916003)
广东省医学科学技术研究基金(A2016521)
关键词
3D打印
计算机辅助
术前规划
髋臼骨折
疗效
3D printing
computer-assisted
preoperative planning
acetabular fracture
outcomes
