摘要
目的 探讨3D打印外置模具辅助下接骨板螺钉外固定微创治疗桡骨远端骨折的治疗效果.方法 回顾性分析2019年6月至2021年5月采用3D打印外置模具辅助下接骨板螺钉外固定治疗桡骨远端骨折并获得随访的15例患者的临床及随访资料.采用标准正、侧位X线片测量术前、术后即刻及术后两年的掌倾角、尺偏角、桡骨长度;测角器测量术后两年腕关节屈曲活动度、背伸活动度;握力计测量术后两年手的握力;视觉模拟量表(VAS)评分评价术前、术后两年腕关节疼痛情况;Gartland-Werley评分评价术后两年腕关节功能恢复.结果 所有患者随访24.0～33.0个月,平均26.5个月.术后两年Gartland-Werley评分优12例,良2例,可1例,腕关节屈曲活动度为(52.0±11.7)°,腕关节背伸活动度为(65.0±4.8)°,患者患侧握力为健侧的(84.0±4.2)％.与术前比较,术后两年患者掌倾角、尺偏角、桡骨短缩值及VAS评分均明显改善(P＜0.05);术后即刻的影像学参数(掌倾角、尺偏角、桡骨短缩)与术后两年比较差异无统计学意义(P＞0.05).结论 3D打印外置模具辅助下接骨板螺钉外固定微创治疗桡骨远端骨折具有可个性化接骨板螺钉、精准制导位置角度、微创、对皮肤软组织条件要求低、取出容易等优势,固定可靠且关节功能恢复良好,短期随访疗效满意.
Abstract
Objective To investigate the curative effect of bone plate screw external fixation minimally invasive treatment assisted with 3-dimensional printing extraposition mold in distal radius fractures.Methods The clinical and follow up data in 15 cases of distal radius fractures treated by bone plate screw ex-ternal fixation minimally invasive treatment assisted with 3-dimensional printing extraposition mold were ret-rospectively analyzed.The volar inclination angle,ulnar deviation angle,radius length at the time of before surgery,immediately after surgery,and 2 years after surgery were measured,by using standard anteroposterior and lateral X-ray films,as well as the wrist jiont flexion extension motion and dorsal extension motion at the time of 2 years after surgery were measured by using protractor.The grip strength of the hand 2 years after surgery was measured by using grip strength meter.Visual Analog Scale(VAS)score was used to evaluate the pain level or wrist joint before and 2 years after surgery;Gartland Werley score was used to evaluate the wrist joint function 2 years after surgery.Results The follow-up lasted for 24.0-33.0 months with an aver-age of 26.5 months.The Gartland-Werley scores were excellent in 12 cases,good in 2 cases and fair in 1 case 2 years after surgery.The wrist joint flexion motion was(52.0±11.7)°,the wrist joint dorsal extension motion was(65.0±4.8)°,the grip strength of the affected side was(84.0±4.2)％of the healthy side.Compared with before operation,the volar inclination angle,ulnar deviation angle and radius shortening value and VAS score up were significantly improved 2 years after surgery(P＜0.05),and there was no statistically significant difference in immediately after surgery imaging parameters(volar inclination angle,ulnar deviation angle and radius shortening)immediately after surgery compared to 2 years after surgery(P＞0.05).Conclusion The bone plate screw external fixation minimally invasive treatment assisted with 3-dimensional printing extrapo-sition mold in distal radius fractures has the advantages of individualized bone plate screw,precision guidance position angle,minimal invasion,low demand for skin and soft tissue condition and easy taking out.The fixa-tion is reliable and the joint function recovered well and the short follow up effect is satisfactory.
维普
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