3D打印技术辅助术前设计和重建肘关节解剖结构1例报告及文献复习

doi:10.13481/j.1671-587x.20190638

吉林大学学报(医学版) ›› 2019, Vol. 45 ›› Issue (06): 1422-1426.doi: 10.13481/j.1671-587x.20190638

3D打印技术辅助术前设计和重建肘关节解剖结构1例报告及文献复习

吴乃超¹, 韩青¹, 李珊², 陈炳鹏¹, 张奥博¹, 刘旸¹, 王金成¹

1. 吉林大学第二医院关节外科, 吉林长春 130041;
2. 吉林大学第二医院皮肤性病科, 吉林长春 130041

收稿日期:2019-02-28 出版日期:2019-12-05 发布日期:2019-12-05
通讯作者: 王金成,教授,博士研究生导师(Tel:0431-81136747,E-mail:jinchengwang@hotmail.com);韩青,讲师(Tel:0431-81136747,E-mail:my.hanqing@163.com) E-mail:jinchengwang@hotmail.com;my.hanqing@163.com
作者简介:吴乃超(1990-),男,山东省泰安市人,在读医学硕士,主要从事骨科3D打印技术应用方面的研究。
基金资助:
国家自然科学基金资助课题（81802174）；吉林省科技厅科技专项基金资助课题（20170204004X，20180520115JH）

3D printing technology-assisted pre-operative design and reconstruction of elbow joint anatomy structure: A case report and literature review

WU Naichao¹, HAN Qing¹, LI Shan², CHEN Bingpeng¹, ZHANG Aobo¹, LIU Yang¹, WANG Jincheng¹

1. Department of Orthopedics, Second Hospital, Jilin University, Changchun 130041, China;
2. Department of Dermatology&STD, Second Hospital, Jilin University, Changchun 130041, China

Received:2019-02-28 Online:2019-12-05 Published:2019-12-05

摘要/Abstract

摘要： 目的：探讨通过3D打印技术辅助进行术前设计指导实施个性化定制肘关节假体置换术的可行性。方法：收治1例右肱骨远端粉碎性骨折术后患者，10年前因摔伤导致肱骨髁粉碎性骨折行切开复位内固定治疗，治疗后因内固定物断裂失效，关节强直及疼痛，活动受限，来本院行肘关节功能重建和缓解疼痛，给予患者3D打印辅助个性化定制肘关节假体置换术治疗，术前通过计算机辅助设计技术联合3D打印技术进行术前设计，模仿重建解剖形态确定截骨范围，以重建解剖形态为基础设计个性化肘关节假体。术中按照术前设计进行截骨并行肘关节重建术。结果：患者手术顺利完成，术中定位显示肘关节假体位置良好，达到术前设计效果，术后随访结果满意，术后6个月患者的关节功能能够满足日常生活行为需要；术后36个月随访肘关节功能评价（HSS）评分由术前的15分恢复为90分。结论：对于复杂的肱骨远端骨折内固定物断裂的患者，可采用计算机辅助设计技术结合3D打印技术进行假体设计和辅助术前设计，实现患者肘关节解剖结构重建及功能恢复。

关键词: 肱骨远端骨折, 内固定物断裂, 3D打印技术, 个性化定制, 肘关节置换

Abstract: Objective: To investigate the feasiblity of 3D printing technology-assisted pre-operative design in guiding the performance of individualized customization elbow joint prosthesis replacement. Methods: A male patient with comminuted fracture of the right distal humerus after operation was selected,the comminuted fracture of the distal humerus was treated with open reduction and internal fixation 10 years ago. Because of internal fixation fracture,the joint appeared stiffness and pain, and the activity was restricted after treatment; the patient was admitted to hospital for elbow joint function recovery and pain relief, and the patient was given the 3D printing technology-assisted individualized customization elbow joint prosthesis replacement. The computer-assisted design technique combined with 3D printing technology was used to simulate the reconstruted anatomly morphology to confirm the osteotomy range;the personalized elbow prosthesis was designed based on the reconstructed anatomy morphology. During the operation, the osteotomy and elbow joint reconstruction were performed according to the design. Results: The operation was successfully completed,and the intraoperative positioning results showed that the elbow joint prosthesis was in good position and achieved the preoperative design effect.The postoperative follow-up result was satisfactory,the activity of elbow joint could satisfy the daily needs of the patient 6 months after operation. Thirty-six months after operation, the HSS score was increased from 15 points before operation to 90 points after operation. Conclusion: For the patients with internal fixation fracture after complicated distal humerus fracture, the computer-aided design technique combined with 3D printing technology can be used to assist the prosthesis design and preoperative design,and the elbow joint anatomy can be reconstructed and the function can be restored by this method.

Key words: distal humerus fracture, internal fixation fracture, 3D printing technology, individualized customization, elbow joint replacement

中图分类号:

R684.7

吴乃超, 韩青, 李珊, 陈炳鹏, 张奥博, 刘旸, 王金成. 3D打印技术辅助术前设计和重建肘关节解剖结构1例报告及文献复习[J]. 吉林大学学报(医学版), 2019, 45(06): 1422-1426.

WU Naichao, HAN Qing, LI Shan, CHEN Bingpeng, ZHANG Aobo, LIU Yang, WANG Jincheng. 3D printing technology-assisted pre-operative design and reconstruction of elbow joint anatomy structure: A case report and literature review[J]. Journal of Jilin University(Medicine Edition), 2019, 45(06): 1422-1426.

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3D打印技术辅助术前设计和重建肘关节解剖结构1例报告及文献复习

3D printing technology-assisted pre-operative design and reconstruction of elbow joint anatomy structure: A case report and literature review

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