Clinical Study Of 3D Printing Technology Assisting Pelvic Salter Osteotomy And Femoral Osteotomy In The Treatment Of Children With DDH

IntroductionObserving children with developmental hip dysplasia,3D printing was used to reconstruct an equal proportion of pelvic femoral model,preoperative pelvic and femoral osteotomy,bone graft internal fixation and other simulation operations,preoperative design,guiding orthopedic surgery Through clinical observation of the system,the clinical efficacy of 3D printing technology in the treatment of developmental hip dysplasia in children was evaluated.MethodsA total of 34 hips with unilateral developmental hip dysplasia who met the inclusion criteria from January 2017 to March 2018 in Wuhan Children's Hospital were randomly divided into experimental groups(group A)according to the admission time of the children.A total of 18 hips and the control group(group B)a total of 16 hips.In the experimental group,the patient model was printed by 3D printing technology,and the malformation evaluation,simulation design,and surgical details were performed.The patients in the control group were deformed by conventional X-ray,CT,three-dimensional reconstruction and other imaging data.The surgical plan was evaluated and designed;the same group of surgeons were treated with conventional Salter pelvic osteotomy and femoral osteotomy.The main clinical observations,complications,and changes in imaging parameters before and after surgery were observed and compared.Inclusion criteria: 1,patients aged 2-6 years;2,X-ray,CT examination confirmed developmental hip dysplasia,acetabular index <45 °,femoral head size and acetabular basic adaptation;3,conservative treatment Failure;4,no surgical contraindications;5,the patient's parents agree to surgery.Exclusion criteria: 1,patients aged < 2 or > 6 years;2,X-ray,CT examination without hip dislocation;3,X-ray,CT examination confirmed developmental hip dysplasia,acetabular index > 45 °;4,there are surgical contraindications,can not tolerate surgery;5,the patient's parents refused.ResultsAll the 34 hips were successfully operated,and there were no blood vessels and nervedamage during the operation.The operation time was from the time of self-cutting to skin suture.The average operation time of the experimental group was(3.02±0.17)h,the intraoperative blood loss was(169±35)ml,and the number of intraoperative fluoroscopy(6.4±1.7)times.The average operation time of the control group was(4.69±0.31)h.The amount of bleeding(241 ± 46 ml),the number of intraoperative fluoroscopy(16.7 ± 2.4)times.The operation time of the experimental group was significantly shorter than that of the control group.The intraoperative blood loss and the number of intraoperative fluoroscopy were also significantly reduced,and the difference was statistically significant(P<0.05).Severin hip X-ray rating and McKay hip function rating were used to evaluate postoperative outcomes.The excellent rate of Severin score was 100%(18/18)in the experimental group and 100%(16/16)in the control group;P>0.05.There was no statistical difference between the two groups.The excellent rate of McKay was 88.89%(16/18),and the control group was81.25%(13/16);P>0.05.There was no significant difference between the two groups.ConclusionsComputer simulation of pelvic osteotomy and femoral osteotomy based on 3D printing allows the surgeon to select the appropriate osteotomy position,the distal rotation angle of the osteotomy and the size of the bone to guide the actual osteotomy.3D printing technology can improve the safety and accuracy of the operation,shorten the operation time,reduce the trauma of the operation to the patient,reduce the occurrence of postoperative complications,and improve the clinical efficacy.