3D打印手术导板结合桥接内固定系统异型块治疗股骨复杂骨折

发布时间：2018-04-14 06:14

本文选题：复杂股骨骨折 + 桥接内固定系统　；参考：《中国矫形外科杂志》2017年22期

【摘要】：[目的]评估3D打印手术导板结合桥接内固定系统异型块技术治疗股骨复杂骨折。[方法]采用此技术治疗股骨粉碎性闭合性复杂骨折患者7例,年龄26~45岁,平均35岁。患肢进行螺旋CT扫描后,采用Mimics软件处理DICOM数据。骨折虚拟复位后,将股骨桥接棒远近段异型块STL文件导入,设计并打印远近段手术导板。术中暴露出股骨远近端皮质,在导板引导下置放桥接棒异型块,连接桥接棒完成间接复位骨折。同时异型块的螺钉也能固定髁部或粗隆间骨折。采用Warden的4-point radiographic scoring system对术后1个月的X线片骨折愈合骨痂评分程度进行评分。[结果]7例完全采用了计划固定方法,患者术中采用的异型块位置与桥接棒长度均与术前计划一致。术中C型臂X线机透视及术后随访X线片及CT显示7例均达到了生物学复位。无明显短缩及旋转移位。术后1个月随访见股骨骨折部均出现明显骨痂生长。Warden评分均为2分。[结论]该方法能够顺利完成股骨全长骨折固定,同时缩短手术时间,骨折段达到生物学固定,术后1个月骨痂生长明显。
[Abstract]:Objective: to evaluate the treatment of complex femoral fractures with 3D printing guided plate combined with bridging internal fixation system.[methods] 7 cases of comminuted closed fracture of femur were treated with this technique. The age was 2645 years (mean 35 years).After spiral CT scanning, DICOM data were processed by Mimics software.After virtual reduction of fracture, the STL file of the distal and proximal segment of the femoral bridging rod was imported, and the surgical guide plate was designed and printed.The distal and proximal femoral cortex was exposed during the operation and the bridging rod was placed under the guide of the guide plate to complete indirect reduction of fracture.At the same time, the screw of the abnormal mass can also fix the condylar or intertrochanteric fracture.4-point radiographic scoring system of Warden was used to evaluate the degree of callus healing of X-ray fracture 1 month after operation.[results] 7 cases were treated with planed fixation. The position of abnormal block and the length of bridging rod were consistent with the preoperative plan.The fluoroscopy of C arm during operation and the follow-up of X ray and CT showed that 7 cases achieved biological reduction.There was no obvious shortening and rotation shift.1 month follow-up showed that the femoral fracture showed obvious callus growth. Warden score was 2 points.[conclusion] this method can successfully complete the fixation of femur full length fracture and shorten the operation time. The fracture segment can reach biological fixation, and the callus grows obviously 1 month after operation.
【作者单位】：山东省千佛山医院骨创伤外二科;
【分类号】：R687.3

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