背景:对于胫骨骨折的畸形愈合,传统的截骨矫形术很难保证术中截骨的准确性.目的:探讨3D打印技术在胫骨畸形截骨矫形手术中的应用效果.方法:选择2015年1月至2017年2月10例胫骨骨折畸形愈合需行截骨矫形的患者(观察组),利用CT数据进行计算机三维建模、3D打印制作截骨导板和术前预演后,行胫骨畸形矫形术.同时随机选取10例采用传统截骨矫形术的病例为对照组.记录两组手术时间、术中出血量、术中透视次数以及术后下肢力线恢复情况.结果:观察组手术时间为(125.5±24.1)min,较对照组明显缩短[(188.0±27.8)min,t=11.63,P<0.05];观察组术中平均透视次数为(4.5±1.1)次,明显少于对照组[(7.5±1.7)次,t=15.64,P<0.05];术后平均随访6.5个月,骨愈合及下肢力线恢复良好.结论:在胫骨畸形截骨矫形术中,3D打印技术可以进行术前设计和手术预演,能够缩短手术时间,提高手术效率,具有一定的临床应用价值.%Background:Usually,it is difficult to ensure the accuracy of osteotomy for the malunion of the tibial fracture. Objective:To investigate the effect of 3-dimensional(3D)printing on tibial fracture malunion.Methods:Ten patients with tibial fracture malunion who underwent osteotomy performed by 3D printing between January 2015 and February 2017 were enrolled in observation group.The surgery was done after 3D modeling,guiding plate manufacture and preoperative rehearsal.Meanwhile,10 patients undergoing traditional osteotomy were randomly selected in control group.The operation time, intraoperative bleeding, fluoroscopy frequency, and the restoration of the lower limb alignment were recorded. Re-sults:The operation time in the observation group was significantly shorter than that in the control group([125.5±24.1]min vs [188.0 ± 27.8] min, t=11.63, P<0.05). Intraoperative use of fluoroscopy in the observation group was significantly less than that in the control group(4.5±1.1 vs 7.5±1.7,t=15.64,P<0.05).The average duration of follow-up was 6.5 months and lower limb alignment recovered well.Conclusions:The 3D printing can be used for the osteotomy of tibial deformity.It can realize preoperative design and operation preview,shorten operation time and improve operation efficiency.
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