Objective To evaluate the clinical outcomes of the anterior pelvic ring fracture under the assis -tance of 3D printing technology.Methods A total of 42 patients(23 males and 19 females aged from 21 -68 (44.2)years) with the anterior pelvic ring fractures received treatment in our hospital from Jan .2014 to Feb. 2017.Among them,27 cases were treated by minimally invasive internal fixation under the assistance of the 3D printing technology (Group A),and 15 cases were treated by open reduction and internal fixation (Group B).The two groups were compared in terms of operation time ,blood loss, postoperative complications ,reduction quality and the function scores of Majeed pelvic fractures at the last follow-up.Results All the 42 patients were followed up for 6 to 24 months (average,13.7 months).Patients in Group A had significantly less operation time in treating the anterior pelvic ring (27.45 ±1.60 min) and blood loss (26.30 ±3.85 mL) than Group B (66.20 ±3.56 min, 128.00 ±8.89 mL)(P<0.05).According to the Matta scoring criteria, the quality of pelvic reduction was evalua-ted as excellent in 20 cases,good in 4 cases,fair in 3 cases in Group A,yielding an excellent and good rate of 88.89％;while was evaluated as excellent in 12 cases,good in 2 cases,and fair in 1 case in Group B,yielding an ex-cellent and good rate of 93.33％.According to the Majeed scoring criteria ,the curative effect was evaluated at the last follow-up and was found excellent in 21 cases,good in 3 cases,fair in 3 cases in Group A,with an excellent and good rate of 88.89％;while was evaluated as excellent in 9 cases,as good in 3 cases,as fair in 3 cases in Group B,yielding an excellent and good rate of 80.00％.The two treatment methods in terms of reduction quality and curative effect had significant differences (P<0.05).One patient presented screw loosening in Group A .In Group B,2 pa-tients developed long-term pains,3 patients developed infection due to excessive obesity and wound fat liquefaction . No nonunion or iatrogenic neurovascular lesion happened during the follow -up period .There was no significant difference between two groups .Conclusion 3D printing technology has the advantages of mini-invasiveness,shor-ter operative time and less postoperative complications .It is a reliable means to treat the anterior pelvic ring frac-tures,and deserves to be widely applied .%目的 评价3D打印技术辅助下微创内固定治疗骨盆前环骨折的临床疗效.方法 回顾性分析2014年1月—2017年2月解放军武汉总医院骨科收治的42例骨盆前环骨折患者资料,其中男性23例,女性19例;年龄21～68岁,平均44.2岁.按手术方法分为两组:A组27例采用3D打印技术辅助下微创内固定治疗,B组15例采用传统切开复位内固定治疗.从手术时间、出血量、术后并发症发生率、术后应用Matta放射学标准评定骨折复位质量、末次随访Majeed骨盆骨折功能评分等方面对两组进行疗效对比研究.结果 42例患者术后获得门诊随访,随访时间6～24个月(平均13.7个月).A组患者骨盆前环手术时间和术中出血量(27.45±1.60)min、(26.30±3.85)mL显著少于B组(66.20±3.56)min、(128.00±8.89)mL,差异均有统计学意义(P<0.05).术后骨折复位质量按骨盆Matta评分标准评定:A组优20例,良4例,可3例,优良率88.89％;B组优12例,良2例,可1例,优良率93.33％.末次随访时按Majeed评分标准评定疗效:A组优21例,良3例,可3例,优良率88.89％;B组优9例,良3例,可3例,优良率80.00％.两组患者骨折复位质量和疗效比较差异均无统计学意义(P>0.05).随访期间A组有1例出现螺钉松动;B组有2例出现前环长期疼痛,3例由于过度肥胖,切口脂肪液化出现感染,经过局部清创缝合后愈合;无1例患者发生骨折不愈合、医源性神经血管损伤等并发症.两组术后并发症发生率差异有统计学意义(P<0.05).结论 3D打印技术辅助下微创内固定与传统切开复位内固定治疗骨盆前环骨折均能获得良好的复位,但前者具有手术时间更短、创伤更小、术后并发症更少等优点,临床值得推广应用.
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