目的 探讨3D打印结合虚拟手术辅助治疗C型桡骨远端骨折手术的效果.方法 将17例C型桡骨远端骨折患者术前薄层CT扫描的数据适当处理后导入3D打印机,快速定制模型以分析骨折具体情况,同时在计算机上进行虚拟的复位内固定手术后,制定详细的手术计划.严格按照计划实施手术,记录手术时间、术中出血量、骨折愈合时间、复位情况和腕关节功能恢复情况.结果 手术时间28～76 min,术中出血量20～75 ml.患者均获得随访,时间6～18个月.骨折全部愈合,时间为8.2～11.5周.术后6个月时,影像学测量桡骨高度为7.2～12.7 mm,掌倾角为7.1°～14.9°,尺偏角14.8°～27.3°;采用改良Sarmiento系统评估骨折复位情况:优10例,良6例,可1例;采用Dienst标准评估腕关节功能:优12例,良4例,可1例.结论 借助3D打印技术快速定制骨折模型,术者可以直观、深入地观察C型桡骨远端骨折情况;通过计算机数字化虚拟手术,按照定制的术前计划实施精准手术,可以提高实际手术的效率,提高治疗效果满意度.%Objective To investigate the radiologic and functional outcome following internal fixation of type-C distal radius fractures assisted with 3D printing technique and virtual surgery. Methods Total 17 type-C distal radius frac-tures patients underwent open reduction and internal fixation(ORIF) assisted with 3D printing technique and virtual surgery. According to the data of CT scan, models of fractures used for classification were produced by 3D printer. The virtual surgery was completed on the computer, and preoperative planning was made at the same time. The real surgical procedures were carried out accurately according to the preoperative planning. The durations of operations and volume of blood loss were recorded. Healing time, fracture reduction, and wrist function recovery were evaluated when follow-up after surgery. Results The durations of operations were 28～76 min, and volume of intraoperative blood loss was 20～75 ml. All cases were followed up for 6～18 months. All fractures healed with time of 8.2～11.5 weeks. At 6 months postoperation, radial height was 7.2～12.7 mm, palm tilt angle was 7.1° ～14.9°, deviation angle was 14.8°～27.3°. According to the Sarmiento criteria, the results were excellent in 10 cases, good in 6, fair in 1. For wrist functional assessment, the patients were assessed by the Dienst scale criteria, the results were excel-lent in 12 cases, good in 4, fair in 1. Conclusions The 3D printing models are helpful for surgeons to have a direct visualization of the fractures. And virtual surgery can provide patient-specific preoperative planning, which make ac-curate surgery be possible. The radiologic and functional outcome of type-C distal radius fractures treated by ORIF as-sisted with 3D printing technique and virtual surgery are satisfied.
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