摘要
目的:探讨数字化中医手法复位结合3D打印小夹板外固定治疗A型桡骨远端骨折的近期疗效,探索中医手法复位的量化及小夹板固定的个性化改进。方法:病例均来自河北省沧州中西医结合医院门诊就诊的A型桡骨远端骨折患者,共50例,女22例,男28例;年龄25~75岁;左侧27例,右侧23例;分为治疗组和对照组,各25例。治疗组男13例,女12例;年龄(56.2±5.5)岁。治疗组患者治疗方法:首先,采用Mimics Research软件对获取的完整的患肢CT数据进行全方位分析,形成三维模型;然后,将患肢骨骼以及皮肤轮廓的STL格式三维模型分别导入至Materialise Magics 23.0软件中,对模型进行处理和修复,并模拟复位,记录位移数据形成“数字处方”,以此指导和量化中医手法操作;最后,应用3D打印的个性化小夹板进行固定治疗。对照组男15例,女10例;年龄(53.32±5.28)岁;给予中医手法复位结合传统小夹板固定。通过观察骨折临床愈合时间、骨折复位质量、治疗6周Gartland-Werley腕关节评分、治疗6周的X线参数评价(掌倾角、尺偏角、桡骨高度),比较两组临床疗效。结果:治疗组达到临床愈合所需时间少于对照组(P<0.05);治疗6周后,治疗组腕关节功能评分及优良率优于对照组(P<0.05);在治疗后6周的影像学参数(掌倾角、尺偏角、桡骨高度)方面治疗组优于对照组(P<0.05)。结论:在数字模拟处方量化复位后的皮肤轮廓的基础上、依据小夹板固定的作用机制,设计的3D打印小夹板在有效固定骨折的同时,使骨折固定局部更加贴附,固定更加牢固,佩戴更加舒适,实现骨折的个性化治疗,为A型桡骨远端骨折的治疗提供了一种新型的、个体化、精准化的治疗方案。
Objective To explore the short-term efficacy of digitally-assisted traditional Chinese medicine manual reduction combined with 3D printed splint in the treatment of AO type-A distal radius fractures,and explore the quantification of traditional Chinese medicine manual reduction and personalized improvement of splinting.Methods The clinical data of 50 patients with AO type-A distal radius fractures,who received treatment at the outpatient department of Cangzhou Integrated Traditional Chinese and Western Medicine Hospital in Hebei Province,were retrospective analyzed.The patient cohort included 22 females and 28 males,with ages ranging from 25 to 75 years old.Among them,27 cases presented with distal radius fractures on the left side,and 24 cases on the right side.The patients were categorized into two groups:treatment group(n=25)and control group(n=25).There were 13 males and 12 females in the treatment group,with an average age of(56.2±5.5)years old.Treatment approach for this group involved several steps.Initially,Mimics Research software was used to conduct comprehensive analysis of complete CT data from the affected limb,resulting in the creation of a three-dimensional model.Subsequently,3D models of the bones and skin contours,stored as STL format files,were imported into the Materialise Magics 23.0 software for model processing and repair.This facilitated the simulation of reduction and recording of displacement data,effectively generating a"digital prescription"to guide and quantify traditional Chinese medicine manipulation procedures.Finally,a personalized 3D printed splint was applied for fixation treatment.There were 15 males and 10 females in the control group,with an av erage age of(53.32±5.28)years old.These patients were treated with manualreduction combined with traditional splinting.The clinical efficacy of the two groups was assessed in terms of fracture reduction quality,fracture healing time,Gartland-Werley wrist joint score and X-ray parameters(palminclination angle,ulnar deviation angle,radius height)at 6 weeks post-operatively.Results The treatment group exhibited a shorter duration for achieving clinical healing compared to the control group(P<0.05).Six weeks post-operatively,the treatment group demonstrated higher wrist joint function scores,and a higher proportion of excellent and good outcomes than the control group(P<0.05).The treatment group was superior to the control group in terms of imaging parameters 6 weeks post-operatively(P<0.05).Conclusion By quantifying skin contours through digital simulation prescription reduction,a personalized 3D printed splint is developed to effectively stabilize fractures,enhancing localized fixation while ensuring greater adherence,stability,and comfort.This innovative approach offers personalized treatment for AO type-A distal radius fractures and presents a novel,precise treatment strategy for consideration.
作者
李国梁
赵建勇
李晓明
王铁强
陈康
刘其林
LI Guo-liang;ZHAO Jian-yong;LI Xiao-ming;WANG Tie-qiang;CHEN Kang;LIU Qi-lin(Minimally Invasive Orthopedics Department,Cangzhou Integrated Traditional Chinese and Western Medicine Hospital,Cangzhou061000,Hebei,China)
出处
《中国骨伤》
CAS
CSCD
2023年第9期809-814,共6页
China Journal of Orthopaedics and Traumatology
基金
河北省人力资源和社会保障厅基金项目(编号:C20221124)。
关键词
桡骨远端骨折
数字骨科
中医手法整复
3D打印小夹板
Distal radius fracture
Digital orthopedics
Traditional Chinese medicine manual and reduction
3D printed splint
