3D打印技术在Pilon骨折手术治疗中的应用

李新春， 康麟， 庞渊

(乌鲁木齐市中医院骨科， 乌鲁木齐830011)

摘要：目的探讨3D打印技术在 Pilon骨折手术治疗中的可行性及诊疗价值。方法选择2例较为复杂的 Pilon骨折患者进行螺旋CT扫描，将其DICOM数据输入计算机中，采用 Mimics软件处理数据。应用3D打印技术打印骨折模型，制定手术方案，于内固定前模拟手术过程。然后实施手术，从手术入路、钢板长度、螺钉数量及长度方面与术前模拟方案进行对比。 结果2例完全采用了计划固定方法，患者术中采用的固定钢板、螺钉数量与螺钉长度均与术前计划一致。随访 X线及 CT显示2例均为关节面解剖复位。 结论3D打印技术应用于Pilon骨折的治疗临床可行性良好，有助于术者对Pilon骨折的理解和术前计划的制定。

关键词：3D打印技术； Pilon骨折； 临床应用

中图分类号：R683文献标识码：A

doi:10.3969/j.issn.1009-5551.2015.04.020

[收稿日期：2014-10-14]

基金项目：乌鲁木齐市科技局资助基金(Y121310007)

作者简介：韩晓丽(1974-)，女，硕士，副主任医师，研究方向：营养与健康。

Application of 3D printing technology in the clinical treatment of pilon fracture

LI Xinchun, KANG Lin, PANG Yuan

(DepartmentofOrthopedics,UrumqiHospitalofTraditionalChineseMedicine,

Urumqi830011,China)

Abstract：ObjectiveTo explore the feasibility and clinical value of three-dimension (3D) printing technology in the treatment of Pilon Fracture. MethodsSpiral CT scan was performed in 2 patients with Pilon Fracture. DICOM data were imported into Mimics software. 3D printing technology was used to print the fracture models. Operative planning was worked out, and the surgical process was simulated before internal fixation, and then the operation was implemented. The aspects including operation approach, plate length, screw count and length were compared. Meanwhile, the actual operation time was recorded. ResultsThe planned fixation method was completely used in 2 patients. The number and length of fixation plate and screw in 2 patients were concurrent with those before operation. The follow-up CT showed that 2 patients achieved anatomic reduction of articular surface. ConclusionThe technology of 3D printing for the treatment of Pilon fracture is feasible and of clinical significance, contributive to the better understanding of Pilon facture and preoperative planning for the operation.

Key words： 3D printing technology; pilon fracture; clinical application

Pilon骨折一直是临床骨科医师比较难以处理的一类骨折，其为胫骨远端累及关节面合并腓骨远端的复杂骨折，多由高处坠落、交通事故以及厂矿工伤等高能量暴力所造成，多有移位及下胫腓关节分离，保守治疗一般效果较差，常出现关节功能障碍、长期的疼痛等较为严重的并发症，需手术治疗。乌鲁木齐市中医院在新疆首次将3D打印技术应用于Pilon骨折中，在CT三维重建技术的基础上，制作出了Pilon骨折的等大原始立体图像，能够为术者提供更为清晰、准确的影像学信息，为患者提供更加直观、易懂的实物模型，具有明显优势。……