The Application Of 3D Printing Technique In Surgical Accurate Correction Of Orbital Fracture

Purpose:To study the effectiveness and safety of individual 3D printed orbital model assisted pre-shaped Medpor artificial bone plate in precise repair of orbital floor fracture.Methods:The clinical date of 21 cases of single-ocular orbital explosive fracture were selected from August 2016 to August 2017.10 cases of patients were randomly divided into experimental group and control group in 11 cases.The experimental group used pre-shaped Medpor artificial bone plate preformed by a 3D printed orbital model,and the conventional Medpor artificial bone plate was used in the control group.As for 3D printing technique-assisted reconstruction surgery,a 3D orbital model is first constructed from patient’s CT images with MIMICS software and printed out by using a 3D printer,and then a simulated artificial bone model is produced according to the fracture zone before operation.The patients were followed up to 3~6 months,and compared the two groups with the difference of orbital volume and eyeball prutrusion,the cure rates of diplopia.To compare the time of operation and the one-time implantation rate of artificial bone plate in the operation.Record the occurrence of complications during the follow-up period.Results:1.The orbital volume:In the control group,there was no statistically significant difference between the orbital volume of the surgical eye and the orbital volume of the lateral healthy eyes(P>0.05).In the experimental group,there was no statistically significant difference between the orbital volume of the surgical eye and the orbital volume of the lateral healthy eyes(P>0.05).There was no statistically significant difference between the two groups in the the difference of orbital volume before operation(P>0.05).In the experimental group,the difference of orbital volume was-0.24±0.41,the control group was 0.44±0.73 respectively.The difference of the two groups was statistically significant(P<0.05).2.The enophthalmos:There was no statistically significant difference between the two groups in the the difference of enophthalmos before operation(P>0.05).In the experimental group,the difference of the degree of the enophthalmos was-0.08±0.36,the control group was 0.37±0.45 respectively.The difference of the two groups was statistically significant(P<0.05).3.Diplopia:No statistically significant between the two groups before operation(P>0.05).Noinefficient and aggravation occurred in both groups afteroperation.In the control group,2 patients were cured,9 were improvement after operation 2 weeks;7 were cured,4 were improvement after operation 3months;8 were cured,3 were improvement after operation 6 months.There was statistically significant between 2 weeks and 3months,between 2 weeks and 6 months after operation(P<0.05),and no statistically significant between 3 months and 6 months after operation(P>0.05).In the experimental group,2 patients were cured,8 were improvement after operation 2 weeks;6 were cured,4 were improvement after operation 3 months;8 were cured,2 were improvement after operation 6 months.There was statistically significant between 2 weeks and 3months,between 2 weeks and 6 months after operation(P<0.05),and no statistically significant between 3 months and 6 months after operation(P>0.05).In the cure rate,there was no statistically significant between the control group and experimental group after operation months(c~2=0.22,P>0.05).4.The operation time:The operation time of the experimental group was 49.50±13.83 min,the control group was 67.91±24.09 min.The time of operation of the experimental group was significantly reduced.5.In the experimental group,the preformed artificial bone plate was implanted in 9 cases(90.00%),and the control group of conventional artificial bone plate was implanted in 2cases(18.18%).6.No serious complications occurred during the two groups of follow-up visits.Conclusions:1.Application of individualized orbital model 3 d printing auxiliary preform Medpor artificial bone plate repair of orbital blowout fracture compared with the traditional operation method,restore the orbital anatomy,more precise repairing orbital volume and improving enophthalmos.2.Application of individualized orbital model 3D printing auxiliary preform Medpor orbital blowout fracture of artificial bone plate can obviously shorten operation time,gain good functional recovery after surgery.