作　　者： (马旭）; (邬波）; (柳椰）; (刘素媛）; (谭成波）; (杨政博）; (王译晗）; (王佳媛）;

机构地区： 沈阳市骨科医院骨科研究所病房,沈阳110044 辽宁省创伤性骨关节病重点实验室,沈阳110044

出　　处： 《中国骨与关节外科》 2017年第3期228-231,共4页

摘　　要： 背景:当肘关节出现肱骨髁间粉碎性骨折或尺骨鹰嘴粉碎性骨折等复杂骨折时,骨折碎块隐蔽分布于关节附近的韧带、关节囊中,手术治疗难度大,不易复位。目的:探讨3D打印实体模型应用于肘关节骨折疾病中的临床效果。方法:选择我院2014年10月至2015年10月收治的患有肱骨髁间粉碎性骨折、尺骨鹰嘴粉碎性骨折、肱骨髁间粉碎性骨折合并尺骨鹰嘴粉碎性骨折需行肘关节骨折手术的患者42例,随机分为实体模型组(16例)和对照组(26例)。实体模型组术前采集CT扫描数据,并通过3D打印机制作患者患处实体模型。对照组使用传统方法进行手术操作。对两组患者术前、术后3个月进行Mayo标准评分;记录所有病例手术时间、术中失血量;比较两组关节活动度及骨折愈合时间。结果:实体模型组手术前后Mayo肘关节评分分别为(42.6±6.7)分和(96.2±3.8)分。对照组手术前后Mayo肘关节评分分别为(44.3±5.5)分和(91.1±4.3)分。两组术后Mayo肘关节评分均较术前显著提高,且术后实体模型组的Mayo肘关节评分显著高于对照组(P<0.05)。术后实体模型组的优良率较对照组亦有所提高(P<0.05)。实体模型组平均手术时间和术中失血量均显著少于对照组(P<0.05)。实体模型组关节活动范围明显大于对照组(P<0.05),但两组骨折愈合时间未见明显差异(P>0.05)。结论:在肘关节骨折疾病的治疗中应用3D打印实体模型,可以取得更好的临床疗效。 Background： When humeral condylar comminuted fracture or comminuted olecranon fracture at elbow happens,the fracture fragments are snugly distributed in ligaments and capsules, which will increase the difficulties of surgical treatment and restoration. Objective： To explore the clinical efficacy of 3D printing entity model in elbow fracture. Methods： Forty-two patients who suffered from humeral condylar comminuted fracture, comminuted olecranon fractures, or humeral condylar comminuted fracture combined with comminuted olecranon fractures and underwent surgical treatment in our hospital between October 2014 and October 2015 were randomly divided into two groups： entity model group（n=16） and control group（n=26）. Before surgery, the entity model was printed out based on CT scan results in entity model group. Conventional surgical operation was performed in control group. The Mayo score was assessed before operation and 3 months after operation. The operation time, intraoperative blood loss and the range of motion of elbow joint, fracture healing time were compared between the two groups. Results： The Mayo score was 42.6±6.7 and 96.2±3.8 before and after surgery in the entity model group. The Mayo score was 44.3 ± 5.5 and 91.1 ± 4.3 before and after surgery in the control group. Postoperative Mayo score was significantly higher than preoperative one in both groups（P〈0.05）. The Mayo score and excellent rate of treatment in the entity model group were significantly higher than those in the control group（P〈0.05）. The operation time and intraoperative blood loss in the entity model group were significantly less than those in the control group（P〈0.05）. The range of motion of elbow joint in the entity model group was significantly greater than that in the control group（P〈0.05）,but no significant difference was found in the fracture healing time between the two groups（P〉0.05）. Conclusions： 3D Printing entity model plays a good role in complex elbow fracture.

关 键 词： 打印技术 实体模型 肘关节骨折