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3D打印技术辅助治疗青少年胫骨远端骨骺骨折的临床进展
Clinical progress of 3D printing technology in treatment of distal tibial epiphyseal fractures in adolescents
- 局解手术学杂志 2023年32卷第12期 页码：1082-1086
- 作者机构：
1.南京医科大学附属无锡人民医院儿外科，江苏 无锡 214023
2.无锡市儿童医院骨科，江苏 无锡 214023
- 作者简介：
张爱国，E-mail：hazag@163.com
- 基金信息：
DOI：10.11659/jjssx.02E023062
中图分类号： R683.42纸质出版日期：2023-12-25，
收稿日期：2023-02-13，
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文小林,岳莹,顾靖钏等.3D打印技术辅助治疗青少年胫骨远端骨骺骨折的临床进展[J].局解手术学杂志,2023,32(12):1082-1086.
WEN Xiao-lin,YUE Ying,GU Jing-chuan,et al.Clinical progress of 3D printing technology in treatment of distal tibial epiphyseal fractures in adolescents[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(12):1082-1086.
文小林,岳莹,顾靖钏等.3D打印技术辅助治疗青少年胫骨远端骨骺骨折的临床进展[J].局解手术学杂志,2023,32(12):1082-1086. DOI： 10.11659/jjssx.02E023062.
WEN Xiao-lin,YUE Ying,GU Jing-chuan,et al.Clinical progress of 3D printing technology in treatment of distal tibial epiphyseal fractures in adolescents[J].JOURNAL OF REGIONAL ANATOMY AND OPERATIVE SURGERY,2023,32(12):1082-1086. DOI： 10.11659/jjssx.02E023062.
摘要
胫骨远端骨骺骨折是青少年常见的骨折类型。胫骨远端邻近踝关节，此处骨骺脆弱，发生骨折时易损伤骨骺，导致骨骺缺血坏死及骨骼生长障碍，且损伤程度和治疗效果直接影响踝关节的形态和功能，严重影响患儿预后情况及生活质量。因此，受伤后应尽可能达到解剖复位，实现稳定固定。对于胫骨远端骨骺稳定性骨折（如Salter-Harris Ⅰ型或Ⅱ型骨折），可采用保守治疗；而对于不稳定骨折，特别是移位风险较高的Salter-Harris Ⅲ、Ⅳ型骨折，首选手术治疗。但由于青少年骨骼生理特点，胫骨远端生长发育情况不同，需要根据患儿情况制定个体化治疗方案。3D打印技术结合CT、MRI等影像技术可以打印出复杂形状的几何结构以适应个体需求，在胫骨远端骨骺骨折，特别是Salter-Harris Ⅲ、Ⅳ型骨折手术治疗中起到重要作用，能帮助制定个体化手术方案，提高手术成功率，减少远期并发症发生率，极大改善患儿预后情况。本文结合近十年的文献报道，对3D打印技术在青少年胫骨远端骨骺骨折诊疗中的应用研究进展作一综述。
Abstract
The distal tibial epiphyseal fractures is a common type of fracture in adolescents. The distal tibia is adjacent to the ankle joint， where the epiphysis is fragile and easily damaged when the fracture occurs， resulting in ischemic necrosis of the epiphysis and impaired bone growth， and the degree of damage and treatment effect directly influence the shape and function of the ankle joint， seriously affect the prognosis and quality of life of adolescents. Therefore， anatomical reduction should be achieved after injury as much as possible to achieve stable fixation. For stable fractures of the distal tibial epiphysis （such as Salter-Harris type Ⅰ or Ⅱ fractures）， the conservative treatment can be used； whereas for unstable fractures， especially Salter-Harris type Ⅲ and Ⅳ fractures with a high risk of displacement， surgical treatment is preferred. However， due to the physiological characteristics of the epiphysis of adolescents， the distal tibia grow and develop differently， the individualized treatment plans should be developed according to the situation of adolescents. 3D printing technology combined with imaging technologies including CT and MRI can print complex shapes of geometric structures to meet individual needs， and play an important role in the surgical treatment of distal tibial epiphyseal fractures， especially Salter-Harris type Ⅲ and Ⅳ fractures， which can contribute to formulating individualized surgical plans， improving the success rate of surgery， reducing the incidence of long-term complications， and greatly improving the prognosis of adolescents. Based on the literature reports in the past decade， this paper reviews the research progress of the application of 3D printing technology in the diagnosis and treatment of distal tibial epiphyseal fractures in adolescents.
关键词
3D打印青少年骨骺骨折胫骨骨折Salter-Harris分型法
Keywords
3D printingadolescentepiphyseal fracturetibial fractureSalter-Harris classification
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