[1]周东 吴舒婷 郭卫中 王磊 李铖嵩 苏郁**.3D打印联合经皮微创钢板内固定术在骨盆前环损伤中的应用[J].中国微创外科杂志,2024,01(12):815-819.
　Zhou Dong,Wu Shuting,Guo Weizhong,et al.Application of 3D Printing Combined With Minimally Invasive Percutaneous Plate Osteosynthesis for Anterior Pelvic Ring Injuries[J].Chinese Journal of Minimally Invasive Surgery,2024,01(12):815-819.
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3D打印联合经皮微创钢板内固定术在骨盆前环损伤中的应用()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
01
期数:
2024年12期
页码:
815-819
栏目:
短篇论著
出版日期:
2024-12-25

文章信息/Info

Title:
Application of 3D Printing Combined With Minimally Invasive Percutaneous Plate Osteosynthesis for Anterior Pelvic Ring Injuries
作者:
周东 吴舒婷 郭卫中 王磊 李铖嵩 苏郁**
(福建医科大学附属闽东医院创伤骨科，宁德355000)
Author(s):
Zhou Dong;  Wu Shuting;  Guo Weizhong;  et al.
Department of Traumatic Orthopedics, Mindong Hospital Affiliated to Fujian Medical University, Ningde 355000, China
关键词:
骨盆前环损伤; 3D 打印; 经皮微创钢板内固定术
Keywords:
Anterior pelvic ring injury; 3D printing; Minimally invasive percutaneous plate osteosynthesis
文献标志码:
A
摘要:
目的探讨3D打印联合经皮微创钢板内固定术(minimally invasive percutaneous plate osteosynthesis，MIPPO)治疗骨盆前环损伤的初步临床效果。方法2017年12月~2023年7月我们采用3D打印联合MIPPO治疗骨盆前环损伤15例，术前3D打印建立实体模型，体外模拟手术精准预弯钢板及设计螺钉数量、方向及长度，然后沿骨盆前环骨膜下通道置入术前体外模拟手术已预弯好的内固定物，内外侧切口分别置入术前已规划好的螺钉固定。结果15例均顺利完成手术，无神经、血管损伤等并发症。手术时间(162.9±63.1)min，切口总长度(13.5±2.2)cm，术中透视次数(5.5±1.0)次，术中出血量(456.7±272.5)ml。骨折愈合时间（17.5±1.8）周。15例随访(15.2±3.9)月，Majeed功能评分由术前(18.3±2.3)分显著提高至术后6个月(86.3±60)分(t=-47.313，P=0.000)；骨折复位Matta影像学标准：优14例，可1例，优良率93.3%(14/15)。结论3D打印联合MIPPO治疗骨盆前环损伤可取得良好的临床疗效。
Abstract:
ObjectiveTo investigate preliminary clinical effects of threedimensional (3D) printing combined with minimally invasive percutaneous plate osteosynthesis (MIPPO) in the treatment of anterior pelvic ring injuries.MethodsBetween December 2017 and July 2023, we treated 15 patients with anterior pelvic ring injuries by using 3D printing combined with MIPPO. Before surgery, a 3D model was printed to establish the actual structure, and a steel plate was prebent outside the body to simulate the surgery, as well as the design of number, direction, and length of screws. Then, the prebent internal fixation device was inserted through the bone membrane tunnel in the anterior pelvic ring, and the screws were fixed through both sides of the incision according to the preoperative planning.ResultsAll the 15 patients underwent surgery successfully without complications such as nerve and vascular injury. The operation time was (162.9±63.1)min, the total length of incision was (13.5±2.2)cm, the number of fluoroscopic examinations during the surgery was (5.5±1.0) times, and the amount of blood loss was (456.7±272.5)ml. The fracture healing time was (17.5±1.8) weeks.The 15 patients were followed up for (15.2±3.9) months. The Majeed functional score increased significantly from (18.3±2.3) points before surgery to (86.3±6.0) points at 6 months postoperatively (t=-47.313, P=0.000). The fracture reduction according to the Matta standards showed excellent in 14 patients,fair in one patient,the excellent and good rate being 93.3%(14/15).Conclusion Combination of 3D printing and MIPPO treatment for anterior pelvic ring injuries can achieve good clinical effects.

参考文献/References:

[1]Djaja YP, Silitonga J, Dilogo IH, et al. The management of pelvic ring fractures in lowresource environments: Review. Eur J Orthop Surg Traumatol,2023,33(3):515-523.
[2]Bi C, Wang Q, Nagelli C, et al. Treatment of unstable posterior pelvic ring fracture with pedicle screwrod fixator versus locking compression plate: a comparative study. Med Sci Monit,2016,22:3764-3770.
[3]郭晓山.骨盆骨折微创手术的问题及展望.中华创伤骨科杂志,2019,21(1):90-92.
[4]贾健.骨盆骨折的分类及内固定治疗.中华骨科杂志,2002,22(11):695-698.
[5]周东,苏郁,吴舒婷,等.3D打印辅助开放复位内固定移位型髋臼骨折.中国矫形外科杂志,2023,31(18):1670-1675.
[6]Matta JM, Tornetta P 3rd. Internal fixation of unstable pelvic ring injuries. Clin Orthop Relat Res,1996,(329):129-140.
[7]Majeed SA. Grading the outcome of pelvic fractures. J Bone Joint Surg Br,1989,71(2):304-306.
[8]Scheyerer MJ, Osterhoff G, Wehrle S, et al. Detection of posterior pelvic injuries in fractures of the pubic rami. Injury,2012,43(8):1326-1329.
[9]刘敏,周晓赛,刘良乐,等.不同固定方法治疗Tile C型骨盆骨折的生物力学稳定性比较.医用生物力学,2018,33(5):423-428.
[10]Santoro G, Braidotti P, Gregori F, et al. Traumatic sacral fractures: navigation technique in instrumented stabilization. World Neurosurg,2019,131:399-407.
[11]陈开放,段德胜,熊泽康,等.3D打印技术辅助高位髂腹股沟入路治疗复杂髋臼骨折.中华骨科杂志,2017,37(13):786-792.
[12]Upex P, Jouffroy P, Riouallon G. Application of 3D printing for treating fractures of both columns of the acetabulum: Benefit of precontouring plates on the mirrored healthy pelvis. Orthop Traumatol Surg Res,2017,103(3):331-334.
[13]张玉东,吴仁愿,谢丁丁,等.3D打印技术对骨盆骨折治疗效果影响的Meta分析.中国骨伤,2018,31(5):465-471.
[14]Huang JH, Liao H, Tan XY, et al. Surgical treatment for bothcolumn acetabular fractures using preoperative virtual simulation and threedimensional printing techniques. Chin Med J(Engl),2020,133(4):395-401.
[15]Du MM, Wang AG, Shi XH, et al. Safety precautions for the corona mortis using minimally invasive ilioinguinal approach in treatment of anterior pelvic ring fracture. Orthop Surg,2020,12(3):957-963.
[16]Cole PA, Gauger EM, Anavian J, et al. Anterior pelvic external fixator versus subcutaneous internal fixator in the treatment of anterior ring pelvic fractures. J Orthop Trauma,2012,26(5):269-277.
[17]Keltz E, Keshet D, Peled E, et al. Interobserver and intraobserver agreement for Letournel acetabular fracture classification system using 3dimensional printed solid models. World J Orthop,2021,12(2):82-93.
[18]Liu ZJ, Jia J, Zhang YG, et al. Internal fixation of complicated acetabular fractures directed by preoperative surgery with 3D printing models. Orthop Surg,2017,9(2):257-260.

备注/Memo

备注/Memo:
基金项目：福建省自然科学基金项目（2020J011339，2024J011636）**通讯作者，Email：suyu6518@163.com
更新日期/Last Update: 2025-02-27