3D打印辅助桥接组合固定THA股骨假体周围骨折△（开放获取）

3D printing assisted bridge combination fixation for periprosthetic fractures of proximal femur

摘要:

[目的] 评价 3D 打印辅助桥接组合固定 Vancouver B1 和 C 型股骨假体周围骨折的临床疗效。[方法] 回顾性分析 2016 年 3 月—2022 年 5 月 3D 打印辅助桥接组合固定 Vancouver B1 型和 C 型 27 例股骨假体周围骨折患者的临床资料，评价临床及影像结果。[结果] 27 例患者中，Vancouver B1 型骨折 15 例， Vancouver C 型 12 例。两组手术时间 [(107.3±18.7) min vs (119.2±19.3) min, P=0.713] 和术中出血量 [(385.3±114.1) mL vs (420.8±160.2) mL, P=0.381] 的差异均无统计学意义。随访期间无伤口感染、内固定松动、骨折不愈合或畸形愈合等并发症发生。两组患者骨折愈合时间 [(3.8±1.3) 个月 vs (4.2±1.6) 个月, P= 0.258]、伤前 Harris 评分 [(86.3±3.5) vs (86.9±3.3), P=0.903] 和翻修内固定后 12 个月 Harris 评分 [(84.3±3.4) vs (85.2±3.1), P=0.785] 的差异均无统计学意义。[结论]3D 打印辅助桥接组合固定 THA 术后 Vancouver B1 和 C 型股骨假体周围骨折，近、中期临床效果良好，两个骨折类型的治疗效果无显著差异。

关键词:股骨假体周围骨折;桥接组合固定;3D 打印;Vancouver 分型

Abstract:

[Objective] To evaluate the clinical efficacy of 3D printing-assisted bridging combination fixation of Vancouver type B1 and C periprosthetic fractures of the femur. [Methods] A retrospective study was conducted on 27 patients who had Vancouver type B1 and type C periprosthetic fractures fixed by 3D printing assisted bridging combination fixation from March 2016 to May 2022. The clinical and imaging documents were evaluated. [Results] Of the 27 patients, there were 15 cases of Vancouver type B1 fractures and 12 cases of Vancouver type C fractures. There were no significant differences in operation time [(107.3±18.7) min vs (119.2±19.3) min, P=0.713] and intraoperative bleeding [(385.3±114.1) mL vs (420.8±160.2) mL, P=0.381] between the two groups. No complications such as wound infection, loose internal fixation, fracture nonunion or malunion occurred in anyone of them during follow-up. There were no significant differences in fracture healing time [(3.8±1.3) months vs (4.2±1.6) months, P=0.258], Harris score before injury [(86.3±3.5) vs (86.9±3.3), P= 0.903] and Harris score 12 months after revision [(84.3±3.4) vs (85.2±3.1), P=0.785] between the two types of the fractures. [Conclusion] 3D printing-assisted bridging combination fixation of Vancouver type B1 and C periprosthetic fractures of the femur after THA achieves satisfactory short-medium term clinical consequence, and there is no significant difference in the treatment outcome between the two fracture types.

Key words:periprosthetic fracture of femur; bridge combination fixation; 3D printing; Vancouver typing