| Objective The use of 3D printing rapid prototyping modeling technology to manufacture 1:1 pelvic fracture model,custom personalized surgical treatment program,combined with clinical orthopedic treatment of three cases of bone fracture and traditional experience in the choice of surgical treatment of pelvic fracture clinical efficacy comparison study.Methods Patients in our hospital from April 2013 to April 2017 undergoing pelvic fracture surgery were selected as experimental group A(experimental group);The hospital from January 2009 to March 2014 surgery pelvic fracture patients as a control group B(conventional group)for comparative study analysis.here were 25 cases in group A and 5 cases in female and 20 cases,with a mean age of(46.76 ±13.9)years.According to Tile classification,there were 8 cases of type B1,6 cases of type B2,3 cases of type B3,3 cases of type C1,2 cases of type C3 in 3 cases,In group B,there were 28 patients,21 males and 7 females,with an average age of(48.96 ± 11.81)years.According to Tile pelvic fracture classification,there were 6cases of type B1,7 cases of type B2,2 cases of type B3,For example,C2 type 5 cases,C3 type 2 cases,there was no significant difference between the two groups in gender,age and type(p> 0.05).Group A: The patients underwent pelvic CT scan preoperatively,the plain scan image was exported and saved as DICOM format,the model was imported into Mimics,the solid model was printed,the preoperative planning was performed according to the solid model,the internal fixation model;Group B: The patient also completed pelvic CT scan and other auxiliary examination,according to the pelvic CT and other imaging data with the experience of the surgeon to choose the treatment of intraoperative fractures in accordance with the internal fixation of plastic surgery,nailing and other fixed.A group dialectical treatment of traditional Chinese medicine on the first day after admission,according to the fresh pelvic fracture dialectical belong to the early dialectical treatment of three fractures,early to Tao hong si wu tang promote blood circulation and relieve pain;Mid-term use he ying zhi tong tang to pain relief and thrombosis prevention,you gui yin use late to promote fracture healing.After operation,the operation time,intraoperative blood loss,average length of stay,postoperative reexamination X-ray assessment of the reset quality,postoperative recovery Majeed score.Result After operation,53 patients were followed up for 6-12 months,of which 1patient in group A and 2 patients in group B were lost to follow-up.The rest of the patients were healed for the first time after surgery,with no infection or suppurative osteomyelitis.In group A,there was no nerve injury,and in one case abdominal pain,abdominal distention,constipation and other symptoms were observed.Six patients with different degrees of lateral femoral cutaneous nerve injury were pulled and 9patients showed remission after symptomatic treatment.The mean operative time was(157.42 ± 13.11)min in group A,the amount of intraoperative blood loss was(414.12± 43.09)ml in group A and(18.05 ± 1.49)day in hospitalized in group A,the operative time in group B was(198.46 ± 17.73)min,the amount of intraoperative blood loss was(557.89 ± 68.99)ml,the average length of stay(22.65 ± 2.30)day,the two groups of data were statistically significant.(P = 0.00 <0.05);In group A,there was no nerve injury in group A,and in group B there were 6 patients with different degrees of lateral femoral cutaneous nerve injury(χ2=9.29,P=0.012<0.05).Postoperative complications in group A occurred in abdominal pain,abdominal distention,constipation and other symptoms.Nine patients in group B experienced remission after symptomatic treatme(χ2=7.23,P=0.012<0.05).According to the standard of Matta reduction,the excellent and good rate of reduction in group A was 87.5% in group A(excellent 13,well8,ordinary 2,poor 1)and 61.5% in group B(excellent 7,well 9,ordinary6,poor 4)(χ2= 4.37 p = 0.037 <0.05),the satisfactory rate of postoperative rehabilitation Majeed score was 91.7% in group A(excellent 16 well 6 ordinary 2 poor 0)and significantly higher than that in group B(excellent 10 well 8 ordinary6 poor 2)(p = 0.048 <0.05).Conclusion 3D printing technology is a personalized treatment method.Using the pelvic model to better formulate detailed preoperative treatment programs can improve the accuracy and safety of pelvic fracture surgery.Joint oral orthopedics department can dialectically improve the pelvis The effect of postoperative fracture treatment has good application prospects. |
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