计算机辅助设计与快速成形技术在复杂髋臼骨折切开复位内固定术中的应用
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作者Author单位AddressE-Mail
胡维界 HU Wei-jie 庆阳市第二人民医院骨科, 甘肃 庆阳 745000 Department of Orthopaedics, the Second People's Hospital of Qingyang, Qingyang 745000, Gansu, China huweijie175@163.com 
刘峰 LIU Feng 庆阳市第二人民医院骨科, 甘肃 庆阳 745000 Department of Orthopaedics, the Second People's Hospital of Qingyang, Qingyang 745000, Gansu, China  
张军钰 ZHANG Jun-yu 庆阳市第二人民医院骨科, 甘肃 庆阳 745000 Department of Orthopaedics, the Second People's Hospital of Qingyang, Qingyang 745000, Gansu, China  
期刊信息:《中国骨伤》2016年,第29卷,第4期,第302-305页
DOI:10.3969/j.issn.1003-0034.2016.04.003
基金项目:
中文摘要:

目的:探讨利用计算机辅助设计(computer-aided design,CAD)和快速成形技术(rapid prototyping,RP)进行切开复位内固定治疗复杂髋臼骨折的临床及功能疗效.

方法:对2011年6月至2014年1月收治的23例复杂髋臼骨折利用CAD和RP进行切开复位内固定治疗,男14例,女9例;年龄22~68岁,平均39.96岁.骨折按Letournel-Judet分型:双柱骨折(Ⅹ)13例,T形骨折(Ⅷ)5例,前柱及后半横行骨折(Ⅸ)5例.术后采用改良Matta髋臼骨折复位标准评定骨折复位质量,末次随访时采用改良d'Aubigné-Postel功能评分标准评定髋关节功能,并记录随访过程中出现的并发症.

结果:23例患者获随访,时间10~38个月,平均20.6个月.手术时间90~180 min,平均123 min;术中出血量400~1 400 ml,平均728 ml;根据改良Matta髋臼骨折复位标准:解剖复位14例,良好复位8例,不满意复位1例;末次随访时改良d'Aubigné-Postel髋关节功能评分:优15例,良6例,可1例,差1例;随访过程中发现3例创伤性关节炎,1例坐骨神经损伤,1例髋臼脱位,2例异位骨化,1例股骨头坏死.

结论:利用CAD和RP进行切开复位内固定治疗复杂髋臼骨折,具有手术创伤小,出血量少,固定可靠,手术并发症少,安全性高,临床疗效良好等特点,可广泛应用于临床治疗.
【关键词】髋臼  骨折  计算机辅助设计  快速成型  外科手术
 
Application of computer-aided design and rapid prototyping for open reduction and internal fixation of complex acetabular fractures
ABSTRACT  

Objective:To explore the clinical and functional efficacy of the treatment of complex acetabular fractures by open reduction and internal fixation techniques with computer-aided design and rapid prototyping.

Methods:From June 2011 to January 2014,23 complex acetabular fractures were treated in our department,including 14 males and 9 females,with an average of 39.96 years old ranging from 22 to 68 years old. According to Letournel-Judet classification,there were 13 cases of double column fracture,5 cases of T-shaped fracture and 5 cases of anterior-posterior semi-transverse fracture. By the modified Matta radiological system reduction quality was evaluated. Modified d'Aubigné-Postel evaluation system was used to assess functional recovery,and complication were recorded at follow-up.

Results:The 23 patients were followed up from 10 to 38 months (averaged,20.6 months). The operation time for this series ranged from 90 to 180 minutes(averaged,123 minutes). The intraoperative blood bleeding ranged from 400 to 1 400 ml(averaged,728 ml). By the modified Matta evaluation system,14 cases had anatomic reduction,8 cases had satisfactory reduction,and 1 case had dissatisfactory reduction. According to the Modified d'Aubigné-Postel evaluation system at the last follow-up,15 cases were excellent,6 good,1 fair and 1 poor. Postoperative complication,traumatic osteoarthritis were in 3 cases,injury of sciatic nerve in 1 case,acetabulum dislocation in 1 case,heterotopic ossification in 2 cases,and femoral head necrosis in 1 case.

Conclusion:Open reduction and internal fixation techniques with computer-aided design and rapid prototyping can be widely used in clinical treatment of complex acetabular fractures. Because it can lead to limited invasion,less blood loss,rigid fixation,fewer complication,high safety,and satisfactory outcomes.
KEY WORDS  Acetabulum  Fractures  Computer-aided design  Rapid prototyping  Surgical procedures,operative
 
引用本文,请按以下格式著录参考文献:
中文格式:胡维界,刘峰,张军钰.计算机辅助设计与快速成形技术在复杂髋臼骨折切开复位内固定术中的应用[J].中国骨伤,2016,29(4):302~305
英文格式:HU Wei-jie,LIU Feng,ZHANG Jun-yu.Application of computer-aided design and rapid prototyping for open reduction and internal fixation of complex acetabular fractures[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(4):302~305
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