桥接组合式内固定系统联合3D打印技术治疗股骨假体周围骨折疗效观察
Therapeutic effect of Ortho-Bridge system combined with 3D printing technology in the treatment of periprosthetic fractures of the femur
肖飞 1程可可 1雷天润 1左伟 1焦竞 1陈明 1王俊文1
作者信息
- 1. 武汉市第四医院骨科,武汉 430033
- 折叠
摘要
目的 探讨桥接组合式内固定系统联合3D打印技术治疗股骨假体周围骨折的具体方法及优势,为临床提供新选择.方法 2019年12月至2022年12月,应用桥接组合式内固定系统联合3D打印技术治疗股骨假体周围骨折共16例,其中女12例、男4例;年龄(75.2±9.6)岁;致伤原因为交通伤2例,摔伤14例;左侧10例,右侧6例;骨折分型为Vancouver B1型13例,Vancouver C型3例.术前常规进行股骨全长CT扫描+三维重建检查,根据CT数据进行造模并模拟复位,将模拟复位后的股骨全长模型进行3D打印,并于术前1 d在模型上将桥接组合式内固定系统进行预弯、塑形、组配.手术中完成骨折复位及初步固定后,将术前预先塑形的桥接内固定系统置于股骨外侧结合螺钉牢固固定骨折.术后患者每日给予低分子肝素皮下注射预防下肢深静脉血栓形成,并早期进行康复锻炼.每月复查患肢骨折部位X线片直至骨折完全愈合.采用髋关节Harris评分评估患侧髋关节功能.应用SPSS 27.0统计软件分析,计量资料以均数±标准差((x)±s)表示,计数资料采用频数(％)表示.结果 16例患者的随访时间为(7.8±2.3)个月,手术切口均甲级愈合.全部患者骨折均愈合,骨折愈合时间(3.8±1.3)个月.骨折愈合后的髋关节Harris评分(87.9± 6.7)分,优良率93％.无一例发生神经损伤、血管损伤、术后感染、内固定失效等严重并发症.结论 采用桥接组合式内固定系统联合3D打印技术治疗股骨假体周围骨折效果较好,可在临床上推广应用.
Abstract
Objective To explore the specific methods and advantages of using a Ortho-Bridge sys-tem combined with 3D printing technology to treat femoral periprosthetic fractures,and to provide new choices for clinical work.Methods From December 2019 to December 2022,a total of 16 cases of femo-ral pcriprosthetic fractures were treated using a Ortho-Bridge system combined with 3D printing technology,including 12 females and 4 males,aged(75.2±9.6)years.The causes of the patient's injuries were traf-fic injuries(2 cases)and falls(14 cases).There were 10 cases on the left side and 6 cases on the right.There were 13 cases of Vancover B1 and 3 cases of Vancover C fracture classification.Routine CT scan and 3D reconstruction examination of the full length of the femur were performed before surgery.Based on CT data,a model was created and simulated reduction was performed.The simulated reduction model of the full length of the femur was 3D printed,and the Ortho-Bridge fixation system was pre bent,shaped,and assembled on the model one day before surgery.After completing fracture reduction and initial fixation dur-ing surgery,the pre shaped Ortho-Bridge fixation system was placed on the lateral side of the femur and the fracture was securely fixed with screws.Postoperative patients were given daily subcutaneous injections of low-molecular-weight heparin to prevent deep vein thrombosis in the lower limbs,and early rehabilitation exercises were performed.X-ray films of the affected limb fracture site were reviewed monthly until the fracture was completely healed.The hip joint function on the affected side was evaluated using the Harris hip joint score.SPSS 27.0 statistical software was used for analysis.Measurement data were expressed in the form of(x)±s,and counting data were expressed in the form of frequency(％).Results The follow-up time of the 16 patients was(7.8±2.3)months,and the surgical incisions were all Grade A healed.All fractures in the patients healed,with an fracture healing time of(3.8±1.3)months.The Harris score of the hip joint after fracture healing was(87.9±6.7)points,with an excellent and good rate of 93％.No serious complications such as nerve injury,vascular injury,postoperative infection,or failure of internal fixation occurred.Conclusion The use of Ortho-Bridge fixation system combined with 3D printing tech-nology for the treatment of periprosthetic fractures of the femur is effective and can be widely applied in clinical practice.
关键词
假体周围骨折/3D打印/骨折固定术Key words
Periprosthetic fractures/3D printing/Fracture fixation surgery引用本文复制引用
出版年
2024
NETL
NSTL
万方数据