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Application of 3D printing rapid prototyping-assisted percutaneous fixation in the treatment of intertrochanteric fracture

机译:3D打印快速原型辅助经皮内固定在股骨转子间骨折中的应用

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摘要

The aim of the present study was to investigate the application of 3D printing (3DP) rapid prototyping (RP) technique-assisted percutaneous fixation in the treatment of femoral intertrochanteric fracture (ITF) using proximal femoral nail anti-rotation (PFNA). A total of 39 patients with unstable ITF were included in the current study. Patients were divided into two groups: 19 patients were examined using computed tomography scanning and underwent PFNA with SDP-RP whereas the other 20 patients underwent conventional PFNA treatment. Anatomical data were converted from the Digital Imaging and Communications in Medicine format to the stereolithography format using M3D software. The 3DP-RP model was established using the fused deposition modeling technique and the length and diameter of the main screw blade was measured during the simulation. The postoperative femoral neck-shaft angle (NSA), surgery duration, intraoperative and postoperative blood loss, and the duration of hospital stay were recorded and compared with the corresponding values in conventional surgery. No significant differences were observed in mean PFNA size between the implants used and the preoperative planning estimates. It was demonstrated that the 3DP-RP assisted procedure resulted in more effective reduction of the NSA. Furthermore, patients undergoing 3DP-RP experienced a significant reduction in duration of surgery (P<0.01), as well as reductions in intraoperative (P=0.02) and postoperative (P=0.03) blood loss, compared with conventional surgery. At 6 months post-surgery, no cases of hip varus/vague deformities or implant failure were observed in patients that underwent either the 3DP-RP-assisted or conventional procedure. The results of the present study suggest that the 3DP-RP technique is able to create an accurate model of the ITF, which facilitates surgical planning and fracture reduction, thus improving the efficiency of PFNA surgery for ITFs.
机译:本研究的目的是研究3D打印(3DP)快速原型(RP)技术辅助经皮内固定在股骨近端股骨钉抗旋转(PFNA)治疗股骨粗隆间骨折(ITF)中的应用。本研究共纳入39例ITF不稳定患者。将患者分为两组:使用计算机断层扫描检查的19例患者接受了SDP-RP的PFNA治疗,而其他20例接受了常规PFNA治疗。使用M3D软件将解剖数据从“医学数字成像与通信”格式转换为立体光刻格式。使用熔融沉积建模技术建立了3DP-RP模型,并在仿真过程中测量了主螺杆叶片的长度和直径。记录术后股骨颈轴角(NSA),手术时间,术中和术后失血量以及住院时间,并将其与常规手术中的相应值进行比较。在所用植入物和术前计划估计值之间,未观察到PFNA平均尺寸的显着差异。结果表明,3DP-RP辅助手术可更有效地减少NSA。此外,与常规手术相比,接受3DP-RP手术的患者手术时间显着减少(P <0.01),术中(P = 0.02)和术后(P = 0.03)失血量减少。术后6个月,在接受3DP-RP辅助或常规手术的患者中未观察到髋内翻/模糊畸形或植入失败的病例。本研究的结果表明,3DP-RP技术能够创建准确的ITF模型,从而有助于进行手术计划和减少骨折,从而提高PFNA对ITF的手术效率。

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