3D打印阻挡钉导航模板在胫骨骨折髓内钉闭合复位内固定术的临床应用

Clinical Application of 3D Printed Block Nail Navigation Template in Closed Reduction and Internal Fixation of Intramedullary Nail for Tibial Fracture

摘要: 探讨3D打印阻挡钉导航模板辅助髓内钉闭合复位内固定术治疗胫骨骨折应用中置钉精的确度和手术的效果。方法：回顾性分析选取我院2017年8月~2018年11月应用髓内钉加阻挡钉闭合复位内固定术治疗闭合性中下段胫骨骨折40例，按手术方式分为导组(n = 20)和常规组(n = 20)，比较两组手术时间、术中出血量、术中透视次数、髓内钉置入偏移距离。结果：40例患者均顺利完成手术，模板组手术时间少于常规组，P < 0.05；模板组术中X线透视次少数于常规组，P < 0.05；髓内钉在模板组较常规组更为中置，P < 0.05。模板组术中出血量与常规组差异无统计学意义P = 0.814。结论：个体化导航模板的应用提高了髓内钉置入的精确性，缩短了手术时间，减少了患者和术者不必要的X线辐射量。

Abstract: Objective: To investigate the accuracy and surgical effect of 3D printed block nail navigation tem-plate assisted intramedullary nail closed reduction and internal fixation in the treatment of tibial fracture. Methods: A retrospective analysis was performed on 40 cases of closed reduction and in-ternal fixation of intramedullary nails and blocking nails for the treatment of closed middle and lower tibial fractures in our hospital from August 2017 to November 2018. The patients were divid-ed into the guide group (n = 20) and the conventional group (n = 20) according to the surgical meth-od. Results: All the 40 patients completed the operation successfully, and the operation time of the template group was less than that of the conventional group (P < 0.05). Intraoperative X-ray fluor-oscopy was less in the template group than in the conventional group, P < 0.05; Intramedullary nail-ing was more centered in the template group than in the conventional group, P < 0.05. There was no significant difference in intraoperative blood loss between the template group and the conventional group, P = 0.814. Conclusion: The application of individualized navigation template improves the accuracy of intramedullary nailing, shortens the operation time, and reduces the amount of unnec-essary X-ray radiation for patients and operators.