优化设计的3D数字外科导板在陈旧性颧弓骨折精准治疗中的应用
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摘要
目的评估一种优化设计的3D数字外科导板在陈旧性颧弓骨折精准治疗中的应用价值。方法选择2016年6月～2018年6月在四川大学华西口腔医院行手术治疗的陈旧性颧弓骨折患者共27例,随机分为A、B、C三组,每组各9名。A组采用3D打印的数字外科导板引导结合钛板预成形技术治疗颧弓骨折,B组仅应用钛板预成形技术治疗骨折,C组依据术者经验对颧弓骨折进行治疗。将手术疗效的评判标准分为甲、乙、丙三级,比较三组患者的手术效果。结果手术时间:A组B组>C组,乙等率:B组>C组>A组,丙等率:A组 Objective To evaluate the application of modified digital guide plate in precise treatment of old zygomatic arch fractures. Methods 27 patients with old zygomatic arch fracture were randomly divided into three groups. Group A was treated with preformed titanium plates and modified digital guide plate, Group B with preformed titanium plates only and Group C with surgical treatment based on the experience of surgeon. The criteria for judging the curative effect were divided into three grades: Good, Medium and Bad. The postoperative effects of three groups were compared. Results The operation time of group A was shorter than that of group B, and the operation time of group B was shorter than that of group C(P<0.05). The proportion of good effect of group A was higher than that of group B, and The proportion of good effect of group B was higher than that of group C(P<0.05). The proportion of bad effect of group A was lower than that of group B, and The proportion of bad effect of group B was lower than that of group C(P<0.05). Conclusion The postoperative effect of old zygomatic arch fractures assisted by digital surgery is significantly better than that of the surgery based on the experience of surgeon. The modified digital guide plate has a significant advantage over the traditional surgery in the treatment of old zygomatic arch fractures. It shortens the operation time and accurately converts the preoperative design into the real surgery, which realizing the purpose of precision treatment.
引文
[1] 张清彬,东耀峻,李祖兵,等.颧弓骨折分类方法和治疗的临床回顾性研究[J].现代口腔医学杂志,2007,21(3):231-233.
[2] 高丽荣,孙庚林.颧弓骨折坚强内固定的临床研究[J].河北医学,2008,14(1):73-74.
[3] Gomes PP,Passeri LA,Barbosa A.A 5-Year Retrospective Study of Zygomatico-Orbital Complex and Zygomatic Arch Fractures in Sao Paulo State,Brazil[J].Journal of Oral and Maxillofacial Surgery,2006,64(1),63-67.
[4] 孔祥盼,刘冰,步荣发.颧弓骨折的研究现状[J].口腔颌面修复学杂志,2014,15(1):44-47.
[5] Hammer B,Prein J.Correction of post-traumatic orbital deformities:operative techniques and review of 26 patients[J].Journal of Cranio-Maxillofacial Surgery,1995,23(2):81-90.
[6] Stanley RB.Use of Intraoperative Computed Tomography During Repair of Orbitozygomatic Fractures[J].Archives of Facial Plastic Surgery,1999,1(1):19-24.
[7] 郭雯瑾,文世生.C型臂在颧弓骨折手术治疗中的应用[J].甘肃医药,2015,(4):302-303.
[8] Ferreira PM,Marques M,Pinho C,et al.Midfacial fractures in children and adolescents:a review of 492 cases[J].British Journal of Oral & Maxillofacial Surgery,2004,42(6):501-505.
[9] Feng F,Wang H,Guan X,et al.Mirror imaging and preshaped titanium plates in the treatment of unilateral malar and zygomatic arch fractures[J].Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology,2011,112(2):188-194.
[10] 谭小尧,张兴安,李果,等.面中份多发性陈旧性骨折的外科矫治[J].西部医学,2011,23(2):326-327.
[11] Mirnezami R,Nicholson J,Darzi A.Preparing for precision medicine[J].The New England journal of medicine,2012,(6):489-491.
[12] 周明旺,邓昶,李盛华,等.股骨头坏死的精准医疗:概念与模式[J].中国组织工程研究,2018,22(7):1133-1139.
[13] National Research Council (US) Committee on A Framework for Developing a New Taxonomy of Disease.Toward Precision Medicine:Building a Knowledge Network for Biomedical Research and a New Taxonomy ofDisease[M].National Academies Press,2011.
[14] Hemmy DC,David DJ,Herman GT,et al.Three-dimensional reconstruction of craniofacial deformity using computed tomography[J].Neurosurgery,1983,13(5):534-541.
[15] 王珏.数字化技术在颅颌面外科的应用进展[J].中国美容医学,2012,21(8):1434-1437.
[16] 张新凤,董智伟,刘璐,等.3D打印技术在下颌骨缺损治疗中的应用[J].解放军医药杂志,2015,(11):17-20.
[17] 王晓敏,李明兰.3D打印技术在腓骨移植修复下颌骨缺损手术中的应用[J].医药前沿,2017,(35):203-205.
[18] Rek F,Mehndiratta A,von Tengg Kobligk H,et al.3D printing based on imaging data:review of medical application[J].Int J Comput Assist Radiol Surg,2010,5(4):335-341.
[19] Christopher J,Rizzi MD,Timothy Ortlip MD,et al.A novel computer algorithm for modeling and treating mandibular fractures:A pilot study[J].The Laryngoscope,2017,127(2).https://doi.org/10.1002/lary.26086.
[20] Drake VE,Rizzi CJ,Greywoode JD,et al.Midface Fracture Simulation and Repair:A Computer-Based Algorithm[J].Craniomaxillofacial Trauma & Reconstruction,2017.
[21] Modabber A,Gerressen M,Stiller MB,et al.Computer-assisted Mandibular Reconstruction with Vascularized Iliac Crest Bone Graft[J].Aesthetic Plastic Surgery,2012,36(3):653-659.
[22] Shen Y,Sun J,Li J,et al.Special considerations in virtual surgical planning for secondary accurate maxillary reconstruction with vascularised fibula osteomyocutaneous flap.[J].Journal of Plastic Reconstructive & Aesthetic Surgery Jpras,2012,65(7):893.
[2] 高丽荣,孙庚林.颧弓骨折坚强内固定的临床研究[J].河北医学,2008,14(1):73-74.
[3] Gomes PP,Passeri LA,Barbosa A.A 5-Year Retrospective Study of Zygomatico-Orbital Complex and Zygomatic Arch Fractures in Sao Paulo State,Brazil[J].Journal of Oral and Maxillofacial Surgery,2006,64(1),63-67.
[4] 孔祥盼,刘冰,步荣发.颧弓骨折的研究现状[J].口腔颌面修复学杂志,2014,15(1):44-47.
[5] Hammer B,Prein J.Correction of post-traumatic orbital deformities:operative techniques and review of 26 patients[J].Journal of Cranio-Maxillofacial Surgery,1995,23(2):81-90.
[6] Stanley RB.Use of Intraoperative Computed Tomography During Repair of Orbitozygomatic Fractures[J].Archives of Facial Plastic Surgery,1999,1(1):19-24.
[7] 郭雯瑾,文世生.C型臂在颧弓骨折手术治疗中的应用[J].甘肃医药,2015,(4):302-303.
[8] Ferreira PM,Marques M,Pinho C,et al.Midfacial fractures in children and adolescents:a review of 492 cases[J].British Journal of Oral & Maxillofacial Surgery,2004,42(6):501-505.
[9] Feng F,Wang H,Guan X,et al.Mirror imaging and preshaped titanium plates in the treatment of unilateral malar and zygomatic arch fractures[J].Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology,2011,112(2):188-194.
[10] 谭小尧,张兴安,李果,等.面中份多发性陈旧性骨折的外科矫治[J].西部医学,2011,23(2):326-327.
[11] Mirnezami R,Nicholson J,Darzi A.Preparing for precision medicine[J].The New England journal of medicine,2012,(6):489-491.
[12] 周明旺,邓昶,李盛华,等.股骨头坏死的精准医疗:概念与模式[J].中国组织工程研究,2018,22(7):1133-1139.
[13] National Research Council (US) Committee on A Framework for Developing a New Taxonomy of Disease.Toward Precision Medicine:Building a Knowledge Network for Biomedical Research and a New Taxonomy ofDisease[M].National Academies Press,2011.
[14] Hemmy DC,David DJ,Herman GT,et al.Three-dimensional reconstruction of craniofacial deformity using computed tomography[J].Neurosurgery,1983,13(5):534-541.
[15] 王珏.数字化技术在颅颌面外科的应用进展[J].中国美容医学,2012,21(8):1434-1437.
[16] 张新凤,董智伟,刘璐,等.3D打印技术在下颌骨缺损治疗中的应用[J].解放军医药杂志,2015,(11):17-20.
[17] 王晓敏,李明兰.3D打印技术在腓骨移植修复下颌骨缺损手术中的应用[J].医药前沿,2017,(35):203-205.
[18] Rek F,Mehndiratta A,von Tengg Kobligk H,et al.3D printing based on imaging data:review of medical application[J].Int J Comput Assist Radiol Surg,2010,5(4):335-341.
[19] Christopher J,Rizzi MD,Timothy Ortlip MD,et al.A novel computer algorithm for modeling and treating mandibular fractures:A pilot study[J].The Laryngoscope,2017,127(2).https://doi.org/10.1002/lary.26086.
[20] Drake VE,Rizzi CJ,Greywoode JD,et al.Midface Fracture Simulation and Repair:A Computer-Based Algorithm[J].Craniomaxillofacial Trauma & Reconstruction,2017.
[21] Modabber A,Gerressen M,Stiller MB,et al.Computer-assisted Mandibular Reconstruction with Vascularized Iliac Crest Bone Graft[J].Aesthetic Plastic Surgery,2012,36(3):653-659.
[22] Shen Y,Sun J,Li J,et al.Special considerations in virtual surgical planning for secondary accurate maxillary reconstruction with vascularised fibula osteomyocutaneous flap.[J].Journal of Plastic Reconstructive & Aesthetic Surgery Jpras,2012,65(7):893.