Application Of 3D Printing In Complex Tibial Plateau Fractures Of Schatzker ? And ?

Objective:This study focuses on differences in operation time,the amount of bleeding during the operation,incision size,joint function after operation,the cost of surgery and understanding degree of patients to find a more proper operation between Traditional tibial plateau fracture surgery and 3D printing technology assisted tibial plateau fracture surgery.Materials and methods:Collect casesPatients with complex tibial plateau fractures(Schatzker type VI and type V)in Second Affiliated Hospital of Shanxi Medical University during 2014-2016.All cases were closed injury.The patients were divided into 2 groups,.The control group was prepared according to traditional methods,while the observation group using 3D printing technology to guide the operation.All patients agreed and signed informed consent.Case inclusion criteria: Age 18 to 65 years old,men and women are not limited;Closed injury caused by external force;Schatzker type V and type VI tibial plateau fractures.Exclusion criteria: Less than 18 years of age or older than the age of 65;Multiple fractures;Vascular nerve injury;mental disorders not match the operation.Results:39 Patients with complex tibial plateau fractures(Schatzker type VI and type V)were collected and follow up,the number of cases in observation group was 20 cases(The cases for Schatzker type VI and type V is 9 and 11 respectively)and the number of cases in the control group was 19 cases(The cases for Schatzker type VI and type V is 9 and10 respectively).The results of the observation group were similar to those of preoperative 3D CT reconstruction image and 3D printing model,the two coincidence between intraoperative and preoperative simulation was as high as 83.4%.2 groups of patients all had good fracture reduction.The operation time of the observation group(106±15min)was less than that of the control group(148±27min),The difference was statistically significant;The blood loss of the observation group(207.3±26.2 m L)less than the control group(299.3±53.3ml),The difference was statistically significant;The total length of incision(11.93±2.71cm)in the observation group was less than that in the control group(17.00±3.09cm),the difference was statistically significant;The imaging findings showed that the fracture was good and the position of internal fixation was good.All patients were followed up for 6-12 months with an average of 9.7 months,Bone healing was obtained in all patients and There were no complications such as infection,malunion and nonunion.2 cases of knee joint stiffness,which are due to lack of postoperative rehabilitation exercise,The symptoms were improved after the release of the knee joint.In the term of Schatzker VI after operation 6 months or 12 months,the recovery rate of knee joint function was 90.9% in the observation group,which was higher than that in the control group by 70%.The operation cost of the observation group(68±3 thousand)was higher than that of the control group(45 ±2 thousand),The difference was statistically significant.Patients in the observation group and their families on the understanding of surgery(7.7±0.98 points)is higher than the control group(5.6±1.89).Conclusion:During treat the complex tibial plateau fractures(Schatzker V and VI),3D printing technology to help can significantly shorten the operation time,shorten the surgical incision,reduce intraoperative bleeding,improve the patient understanding to the surgical operation,and obtain postoperative knee function.Although the cost of 3D printing is high,it is believed that 3D printing techniques in composite tibial plateau fractures(Schatzker V-type VI)surgery can be promoted with the development and innovation of digital technology and rapid prototyping technology.