3D打印技术在股骨髁上骨折医患沟通中的效果研究

发布时间：2019-07-11 15:16

【摘要】：目的探讨Mimics18.0软件数字化设计结合3D打印骨折模型进行手术规划,术前模拟手术,辅助治疗复杂型股骨髁上骨折内固定及在医患沟通环节的效果研究。方法筛选10例复杂型股骨髁上骨折患者,将患者的骨折部分及全套内固定物的薄层CT数据导入Mimics 18.0软件,进行骨折三维建模、骨折块虚拟复位、建立股骨髁上骨折内固定物标准件库、选取最佳匹配的钢板及螺钉。3D打印出患者1:1的股骨髁上骨折实体模型,术前应用3D打印模型与患者及其家属沟通并进行3D打印模型的效度验证。让患者及其家属直接接触骨折3D模型并观看在模型上按照数字化设计进行模拟手术—将股骨髁上重建板的位置、钉道长度和方向同数字化设计比较,确定术中使用的钢板及螺钉。最后,按照术前模拟演练进行实际手术骨折复位、钢板内固定。结果术前应用3D模型获得了良好的沟通效果,患者及其家属理解度和满意度高。应用3D打印技术模拟手术共植入1块锁定钢板和8枚螺钉,钢板植入的位置、螺钉植入的方向均与数字化术前设计高度一致,钉道长度与数字化术前设计比较无显著性差异(P0.05)。实际手术与模拟手术的手术效果一致。结论数字化设计结合3D打印技术在医患沟通方面效果显著,且实现了复杂型股骨髁上骨折的个体化、精准化治疗,明显减少了患者的术中出血量,缩短了患者的康复周期。
[Abstract]:Objective to investigate the effect of digital design of Mimics18.0 software combined with 3D printing fracture model for surgical planning, preoperative simulation surgery, auxiliary treatment of complex supracondylar fracture of femur and communication between doctors and patients. Methods Ten patients with complex supracondylar fracture of femur were selected. The thin layer CT data of fracture part and complete set of internal fixation were imported into Mimics 18.0 software to carry out 3D modeling of fracture, virtual reduction of fracture block, establishment of standard parts library of internal fixation of supracondylar fracture of femur, selection of best matching plate and screw. 3D printing out the solid model of supracondylar fracture of femur at 1:1. The 3D printing model was used to communicate with the patients and their families before operation, and the validity of the 3D printing model was verified. The patients and their families were asked to contact the 3D model of fracture directly and watch the simulated operation according to the digital design on the model. The position, length and direction of the supracondylar reconstruction plate were compared with the digital design, and the plate and screw used during the operation were determined. Finally, according to the preoperative simulation exercise, the actual surgical fracture reduction and plate internal fixation were carried out. Results the 3D model was used before operation to obtain good communication effect, and the understanding and satisfaction of the patients and their families were high. 3D printing technique was used to simulate the implantation of 1 locking plate and 8 screws. The position of plate implantation and the direction of screw implantation were highly consistent with those of digital preoperative design. There was no significant difference in nail channel length between digital preoperative design and digital preoperative design (P 0.05). The effect of actual operation is consistent with that of simulated operation. Conclusion Digital design combined with 3D printing technology is effective in doctor-patient communication, and realizes the individualized and accurate treatment of complex supracondylar fracture of femur, which can significantly reduce the amount of intraoperative blood loss and shorten the rehabilitation cycle of patients.
【作者单位】：中山市古镇人民医院骨科广东省创伤救治科研中心古镇基地南方医科大学数字医学研究所3D打印中心古镇基地;中山市古镇人民医院泌尿外科;南方医科大学基础医学院人体解剖学教研室广东省医学生物力学重点实验室;
【基金】：广东省科技计划项目(2015A040404022,2014A020212200) 广东省医学生物力学重点实验室开放基金(2016MB003) 中山市科技计划项目(2015B1264)
【分类号】：R687.3

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