内窥镜辅助下3D打印技术治疗颧骨颧弓骨折的临床效果
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摘要
目的探讨内窥镜辅助下应用3D打印技术治疗颧骨颧弓骨折的临床效果。方法选取2例颧骨颧弓骨折患者,术前进行颌骨三维CT扫描,将扫描数据导入Mimics软件进行三维重建,采用3D技术打印出虚拟复位后的仿真颌骨模型,根据颌骨模型确定最佳内固定位置、预弯塑形和螺钉数,完成体外模型模拟手术,再利用内窥镜完成颧骨颧弓骨折断端复位和内固定手术。结果 2例患者颧骨颧弓骨折复位良好,内固定装置固定位置和螺钉植入位置精确,与骨面贴合且稳固,与术前设计高度吻合。术后复查CT未见骨折再断、内固定装置移位、松动、断裂以及排异等并发症发生。结论将3D打印技术应用于颧骨颧弓骨折的治疗,能在术前明确内固定物植入位置、螺钉数并完成预塑形,术中在内窥镜辅助下进行颧骨颧弓骨折复位内固定手术具有术中视野好、骨折复位好、术切口小、出血少、术后疼痛轻等优点,可有效缩短手术时间,提高手术效率。
引文
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[2]张元智,陆声,赵建民,等.数字化技术在骨科的临床应用[J].中华创伤骨科杂志,2011,13(12):1 161-1 165.
[3]宋军,梅益彰,吴增城,等.复杂髋臼骨折复位及内固定的数字技术模拟研究[J].中国临床解剖学杂志,2013,31(4):393-396.
[4]孟国林,刘建,胡蕴玉,等.快速成型模型在制定胫骨平台复杂骨折手术方案中的指导作用[J].中华创伤骨科杂志,2011,13(12):1 135-1 138.
[5]Seres L,Varga E Jr,Kocsis A,et al.Correction of a severe facial asymmetry with computerized planning and with the use of a rapid prototyped surgical template:a case report/technique article[J].Head Face Med,2014,10:27.
[6]Ciocca L,Mazzoni S,Fantini M,et al.A CAD/CAM-prototyped anatomical condylar prosthesis connected to a custommade bone plate to support a fibula free flap[J].Med Biol Eng Comput,2012,50(7):743-749.
[7]Shen Y,Sun J,Li J,et al.Using computer simulation and stereomodel for accurate mandibular Reconstruction with vascularized iliac crest flap[J].Oral Surg Oral Med Oral Pathol Oral Radiol,2012,114(2):175-182.
[8]刘正武,陈进,余东升,等.口内入路内窥镜辅助下摘除髁突矢状骨折片5例[J].广西医科大学学报,2010,27(5):783-784.
[9]Shao Y,Xie L,Li H,et al.Endoscope-assisted repair of zygomatic arch fracture via a short hidden preauricular incision[J].Zhonghua Zheng Xing Wai Ke Za Zhi,2007,23(4):288-290.