CAJ | 학술논문

目的：探讨3D打印技术在胫骨畸形矫形手术中的应用效果。方法选择沈阳军区总医院骨科2014年8月—2015年8月收治的8例胫骨畸形(观察组),通过CT扫描得到的数据进行计算机三维建模、3D打印导板制作和术前预演,行胫骨畸形矫形术。随机选取8例既往未采用手术导板进行截骨矫形的病例为对照组。记录观察组导板制作时间,比较两组手术时间、术中X线“C”型臂机透视次数即术中X线暴露频次。结果观察组导板制作时间(16.5±3.5)h,患者均成功设计制作了手术导板并进行了应用,术区骨面均能与导板准确帖服并引导摆锯截骨成功,矫形后胫骨对位对线均恢复正常,导板在应用过程中未出现变形、断裂。观察组手术时间及术中X线暴露频次均显著少于对照组(P<0.05)。观察组均获随访,时间为1~16个月,平均4.5个月,截骨端均顺利愈合,无感染,对位对线未出现再次移位。结论3D打印技术用于骨科矫形领域,具有能够实现术前个体化设计、进行手术预演、缩短手术时间、减少医源性损伤、提高手术效率等优点,临床应用价值较高。
목적：탐토3D타인기술재경골기형교형수술중적응용효과。방법선택침양군구총의원골과2014년8월—2015년8월수치적8례경골기형(관찰조),통과CT소묘득도적수거진행계산궤삼유건모、3D타인도판제작화술전예연,행경골기형교형술。수궤선취8례기왕미채용수술도판진행절골교형적병례위대조조。기록관찰조도판제작시간,비교량조수술시간、술중X선“C”형비궤투시차수즉술중X선폭로빈차。결과관찰조도판제작시간(16.5±3.5)h,환자균성공설계제작료수술도판병진행료응용,술구골면균능여도판준학첩복병인도파거절골성공,교형후경골대위대선균회복정상,도판재응용과정중미출현변형、단렬。관찰조수술시간급술중X선폭로빈차균현저소우대조조(P<0.05)。관찰조균획수방,시간위1~16개월,평균4.5개월,절골단균순리유합,무감염,대위대선미출현재차이위。결론3D타인기술용우골과교형영역,구유능구실현술전개체화설계、진행수술예연、축단수술시간、감소의원성손상、제고수술효솔등우점,림상응용개치교고。
Objective To investigate the effect of 3-dimensional (3D) printing technology in application of tibia deformity orthomorphia. Methods The 3D modeling, guiding plate manufacture and preoperative rehearsal for the CT scanning data of 8 tibial deformity patients ( observation group) during August 2014 and August 2015 were performed, and then the 8 patients undertook tibial deformity orthomorphia. A total of 8 patients without 3D printing technology were randomly chosen as the control group. The manufacture time of guiding plate was recorded, and values of operation time and intraoperative exposure frequency of C-arm X-ray in the two groups were compared. Results In the observation group, manufacture time of guiding plate was (16. 5 ± 3. 5)h, and all guiding plates were successfully manufactured and used in the operation;bone surface and plate were suitable in the surgical area, and plates successfully guided the osteot-omy, and the tibia deformity was back to normal line after the orthomorphia without deformation or fracture during the guiding process. The values of operation time and intraoperative exposure frequency of C-arm X-ray in the observation group were significantly lower than those in the control group (P<0. 05). The patients in the observation group were fol-lowed up for 1-16 months, and the average time was 4. 5 months. Bones healed well without infection or re-malposition. Conclusion The 3D printing technology in application of tibia deformity orthomorphia may achieve preoperative individ-ualized design and preview, shorten the operation time, reduce iatrogenic injury and improve the operative efficiency.