[Objective]To explore the clinical value of using 3D printed guide to assist sacroiliac screw fixation in the treatment of pel-vic posterior ring injury.[Method]A retrospective analysis was conducted on the clinical data of 45 patients with pelvic posterior ring inju-ry admitted to the trauma orthopedic ward center of our hospital from January 2020 to February 2023.Based on preoperative doctor-patient communication results,21 patients were assisted with 3D guide,while 24 patients were treated with screw placement by freehand tech-nique.The perioperative,follow-up,and imaging data were compared between the two groups.[Results]The 3D group proved significantly superior to the freehand group in terms of surgical time[(84.8±2.6)min vs(113.3±2.2)min,P＜0.001],screw insertion time[(40.9±0.4)min vs(65.3±1.6)min,P＜0.001],number of screw adjustments[(0.8±0.7)times vs(4.0±0.9)times,P＜0.001],and X-ray exposure time[(35.2±0.8)s vs(77.3±1.4)s,P＜0.00l].The average follow-up period lasted for(24.1±7.5)months,and the 3D group resumed full weight-bearing activity significantly earlier than the freehand group[(85.6±2.7)days vs(95.1±0.6)days,P=0.046].Compared with those one month after surgery,both groups of patients showed significant improvements in VAS score,hip extension and flexion,internal-external rotation ROM,and Majeed score at the last follow-up(P＜0.05).The 3D group proved significantly better than the freehand group in terms of VAS score[(2.6±0.3)vs(3.7±0.2),P=0.042],hip extension flexion ROM[(121.2±1.1)° vs(103.2±1.6)°,P=0.046],hip internal and external rotation ROM[(78.0±0.5)° vs(55.5±0.9)°,P＜0.001],and Majeed score[(36.5±2.3)vs(26.8±0.3),P＜0.001]1 month postoperatively,whereas the dif-ferences in aforesaid items became not significant between the two groups since then(P＞0.05).Radiographically,the 3D group was also sig-nificantly better than the freehand group in terms of accuracy of screw placement[cases(％)][excellent/good/poor,19(90.4)/1(4.8)/1(4.8)vs 14(58.3)/7(29.2)/3(12.5),P＜0.001],fracture reduction quality[excellent/good/poor,18(85.7)/2(9.5)/1(4.8)vs 11(45.8)/9(37.5)/4(16.7),P＜0.001],and fracture healing time[＜10 weeks/10～16 weeks/≥ 16 weeks,17(80.9)/3(14.3)/1(4.8)vs 11(45.8)/10(41.7)/3(12.5),P＜0.001].[Conclusion]The 3D printed guide assisted sacroiliac screw fixation for pelvic posterior ring fractures has mini-mal damage and can achieve better early treatment outcomes.
pelvic fracture3D printingsacroiliac screwsretrospective study
NETL
NSTL
万方数据
