3D打印个体化导航模板在儿童下肢畸形8字钢板骨骺阻滞术中的应用
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南京医科大学附属儿童医院

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江苏省重点研发计划(社会发展)项目,BE2019608; 江苏省“科教强卫工程”青年医学人才项目,QNRC201609


Application of 3D printed individualized navigation template in children with lower extremity deformity by epiphysiodesis with 8-plate
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Affiliated Children’s Hospital, Nanjing Medical University

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Science Foundation of Chi Jiangsu Provincial Key Research and Development Program (BE2019608);Young Medical Talents Project of Jiangsu Province “Strengthening Health through Science and Education” (QNRC201609);

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    摘要:

    [目的] 探讨计算机辅助设计(Computer-aided Design, CAD)和3D打印(Three-dimensional Printing, 3DP)技术制备的导板辅助8字钢板在儿童下肢畸形骨骺阻滞术中应用的可行性和精准性。[方法] 2016年1月~2018年12月共37例因膝关节畸形(膝内翻10例、膝外翻27例)需接受8字钢板骨骺阻滞术的患儿被纳入研究,随机将其分为徒手组(17例)和导板组(20例)。比较两组患儿的一般资料、临床结果和影像评估结果。[结果] 所有患者均手术顺利,无严重并发症。导板组比徒手组每块8字钢板置入时间、X射线暴露次数为均显著减少(p<0.05)。影像方面,两组患儿下肢畸形均得到矫正,末次随访时FTA、mMPTA和mLDFA与术前比较均有显著性差异(p<0.05)。 [结论] 本研究设计的3DP个体化导板减少了儿童下肢畸形8字钢板骨骺阻滞术手术时间和术中X射线暴露次数,可辅助8字钢板精准置入。

    Abstract:

    Abstract: [Objective] To explore the feasibility and accuracy of Three-dimensional Printing(3DP) combined navigation template assisted by computer-aided Design (CAD) and 3DP in children with temporary epiphysiodesis of lower extremity deformity.[Methods] From January 2016 to December 2018, a total of 37 children with knee deformity (10 cases of genu varus and 27 cases of genu valgus) requiring temporary epiphysiodesis with 8-plate were included in the study. They were randomly divided into traditional surgery group(17 children) and navigation template group(20 children). The general data, clinical results and imaging evaluation results were compared.in both group.[Results] All the 37 patients had operation performed successfully without serious complication. Compared with the traditional surgery group, the mean operative time of each 8-plate and the average number of X-ray exposures were significantly reduced (P<0.05). In term of radiographic evaluation, The deformities of lower extremities in both groups were corrected, and there were significant differences in FTA, mMPTA and mLDFA at the latest follow-up compared with those before operation(P<0.05).[Conclusion] The individualized 3DP navigation template designed in this study reduces the operative time and the number of intra-operative X-ray exposure times for epiphysiodesis with 8-plate for children with lower extremity deformity, and can assist the precise placement of 8-plate.

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  • 收稿日期:2021-08-18
  • 最后修改日期:2021-11-11
  • 录用日期:2022-02-25
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