3D打印导航内固定技术术前设计钉道位置在股骨颈骨折治疗中的应用

doi:10.3969/j.issn.1006-6233.2020.02.036

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Abstract Objective: To design the hollow nail internal fixation channel and operation navigation device for the patients with femoral neck fracture before operation, and discussed its application value by 3D printing navigation internal fixation technology. Methods: 86 cases with femoral neck fracture admitted in our hospital from January 2015 to June 2017 were randomly divided into the observation group and the control group, with 43 cases in each group. All cases were treated with closed reduction and cannulated screw internal fixation. Patients in the control group received routine operation scheme, while for patients in the observation group, nail path position and navigator were designed by preoperative 3D printing navigation fixation technology. The basic indexes of surgery, postoperative screw distribution, Harris hip function score at 3 and 12 months after surgery, fracture healing status at the end following-up were observed and compared in 2 groups. Results: The duration from admitting to surgery and the duration of surgery in the observation group were much longer than those in the control group, the amount of bleeding during surgery in the observation group was much more than that in the control group, the times of fluoroscopy and of nail piercing in the observation group were much less than those in the control group, the differences were statistically significant (P＜ 0.05). The parallel degree of screws at front and side in the observation group were significantly lower than that in the control group, and the ratio of screw distribution area in the observation group was significantly higher than that in the control group (P＜ 0.05). At 3 months after operation, the Harris hip function score in the observation group was much better than it in the control group (P＜ 0.05). There were no significant differences in Harris hip function score between the two groups at 12 months after operation (P＞ 0.05). There was no significant difference in incidence of fracture nonunion, femoral head necrosis, Garden indexes and Harris hip function score at the end of following-up (P＞ 0.05). Conclusion: Nail path position and navigator designed by preoperative 3D printing navigation fixation technology can effectively guide cannulated screw internal fixation for patients with femoral neck fracture. It can reduce the frequency of fluoroscopy and of nail piercing, and will not increase the risk of adverse prognosis. It helps patients perform functional exercises as early as possible.

Key words： Femoral neck fracture 3D printing Surgical navigation Internal fixation of fracture

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http://www.hbyxzzs.cn/EN/10.3969/j.issn.1006-6233.2020.02.036 OR http://www.hbyxzzs.cn/EN/Y2020/V26/I2/320

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