| 杨茂杰,满在华,郝清海,孟乾,王倩,穆可成,周猛.3D打印模型辅助规划在逆行髓内钉治疗AO/OTA C型股骨远端骨折中的应用[J].济宁医学院学报,2026,49(5):442-447 |
| 3D打印模型辅助规划在逆行髓内钉治疗AO/OTA C型股骨远端骨折中的应用 |
| Clinical value of 3D-printed model-assisted preoperative planning for retrograde intramedullary nailing in AO/OTA type C distal femoral fractures |
| 投稿时间：2025-12-30 |
| DOI：10.3969/j.issn.1000-9760.2026.05.010 |
| 中文关键词: 3D打印 逆行髓内钉 内固定 AO/OTA分型 股骨远端骨折 |
| 英文关键词: 3D printed model Retrograde intramedullary nailing Plate internal fixation AO/OTA classification Distal femoral fracture |
| 基金项目:枣庄市科技发展计划（2024NS111） |
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| 中文摘要: |
| 目的 探究3D打印模型辅助规划在逆行髓内钉治疗AO/OTA C型股骨远端骨折中的应用。方法 回顾性分析2024年1月—2025年5月我院130例AO/OTA C型股骨远端骨折患者临床资料，根据手术方案不同分组，传统组65例采取传统钢板内固定术，3D组65例采取3D打印模型辅助规划逆行髓内钉内固定术。统计两组术中及术后指标、手术并发症、手术效果，比较手术前后血清IL-6、IL-8水平、HSS膝关节评分及ROM、 LDFA。结果 3D组术中出血量、术中透视次数分别为（178.12±15.66）mL、（6.68±1.01）次，低于传统组（247.74±18.52）mL、（11.25±1.34）次，手术时间、术后负重开始时间、影像学愈合时间分别为（80.60± 10.23）min、（9.17±1.44）d、（26.01±3.04）周，短于传统组（122.21±13.77）min、（13.32±2.51）d、（29.52±3.65）周（P＜0.05）；术后 1 d，3D组血清IL-6、IL-8水平较传统组低（P＜0.05）；术后1个月、3个月、6个月，3D组HSS膝关节评分及ROM、LDFA较传统组高（P＜0.05）；术后6个月，两组并发症发生率比较差异无统计学意义（P＞0.05）；术后6个月，3D组手术优良率87.69%较传统组72.31%高（P＜0.05）。结论 3D打印模型辅助规划用于逆行髓内钉内固定术，有助于改善术中及术后指标，纠正下肢力线，恢复膝关节功能，是AO/OTA C型股骨远端骨折患者的可行性方案之一。 |
| 英文摘要: |
| Objective To explore the clinical value of 3D printed model-assisted preoperative planning in the treatment of AO/OTA type C distal femoral fractures with retrograde intramedullary nailing.Methods The clinical data of 130 patients with AO/OTA type C distal femoral fractures admitted between January 2024 and May 2025 were retrospectively analyzed.Patients were divided into two groups according to surgical procedures,with 65 cases in each group.The conventional group underwent conventional plate internal fixation,while the 3D group received retrograde intramedullary nailing with preoperative planning assisted by 3D printed fracture solid models.Intraoperative and postoperative indicators,surgical complications and clinical efficacy were compared between the two groups.Serum levels of IL-6 and IL-8 before and after surgery were detected and compared.The Hospital for Special Surgery (HSS) knee score,range of motion (ROM) and lateral distal femoral angle (LDFA) were evaluated simultaneously.Results The intraoperative blood loss and fluoroscopy times in the 3D group were (178.12±15.66)ml and (6.68±1.01)times respectively,which were lower than (247.74±18.52)ml and (11.25±1.34)times in the conventional group.The operative duration,time to postoperative weight-bearing and radiographic fracture healing time in the 3D group were (80.60±10.23)min,(9.17±1.44)d and (26.01±3.04)weeks,respectively,shorter than (122.21±13.77)min,(13.32±2.51)d and (29.52±3.65)weeks in the conventional group,with statistically significant differences (P＜0.05).On postoperative day 1,serum IL-6 and IL-8 levels in the 3D group were lower than those in the conventional group (P＜0.05).At 1,3 and 6 months after surgery,the HSS knee score,knee ROM and LDFA in the 3D group were higher than those in the conventional group (P＜0.05).There was no statistically significant difference in the incidence of complications between the two groups at 6 months postoperatively (P＞0.05).At 6 months after surgery,the excellent and good rate in the 3D group was 87.69%,higher than 72.31% in the conventional group (P＜0.05).Conclusion The application of 3D printed model-assisted preoperative planning in retrograde intramedullary nailing can optimize intraoperative procedures,alleviate postoperative inflammatory response,effectively reconstruct lower limb alignment and promote the recovery of knee function.It may be considered a feasible surgical option for patients with AO/OTA type C distal femoral fractures. |
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