儿童陈旧性桡骨头脱位3D打印模型形态比较研究

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摘要目的观察3D打印模型在评价儿童陈旧性桡骨头脱位尺骨、桡骨畸形中的作用。方法收集自2016年1月至2017年12月7例桡骨头脱位儿童病例资料，7例均为男性；年龄3～13岁，平均(9.0±0.4)岁；均为BadoⅠ型；左侧3例，右侧4例。受伤至手术时间为2个月~5年。通过双侧尺桡骨全段三维CT扫描，获得数据后通过MIMICS 10.01软件行患侧尺骨与健侧尺骨的三维畸形比较测量。再行3D打印出双侧尺桡骨模型，更直观地观察双侧尺桡骨的形态。结果软件测量显示患侧尺骨存在三维畸形改变。3D打印的双侧尺桡骨模型显示桡骨近端向前或前外脱位，与尺骨的三维形态结构改变。患侧尺骨形态明显改变，表现在正位观尺骨外翻，侧位观尺骨明显前弓，轴位观尺骨旋后。患侧尺骨近端的外侧桡切迹模糊，凹陷不明显。患侧桡骨形态没有明显改变。测量患侧尺骨的长度，1例明显短于健侧。桡骨的长度与健侧比较，没有明显差异。结论 3D打印模型可三维显示陈旧性桡骨头脱位儿童尺骨、桡骨畸形形态，指导术前手术设计。

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关键词 ：儿童, 尺桡骨畸形, 陈旧性, 桡骨头脱位, 3D打印

Abstract：Objective To observe the role of 3D-printed model in evaluating the ulnar and radial deformities of children with chronic radial head dislocation.Methods From January 2016 to December 2017，7 children with chronic dislocation of radial head were included.They were all males.The age ranged from 3 years to 13 years old，with anaverage age of 9.All of them were Bado type Ⅰ.3 cases were affected in left sides and 4 cases in right sides.The time from injury to surgery was 2 months to 5 years.The data were obtained by 3D-CT scan of bilateral forearms and then measured by MIMICS 10.01 software.The bilateral ulnar and radial models were 3D-printed in order to observe the morphology more intuitively.Results Software measurements showed three-dimensional deformity of the affected ulnas.3D-printed bilateral ulnar and radial models showed anterior or anterior-external dislocation of proximal of radius.The shapes of the affected ulnas were obviously changed，which were manifested in the anterior arch deformity in the sagittal plane，valgus deformity in the coronal plane，external rotation deformity in the axial plane.The lateral radial notches of the proximal ulnas of the affected sides were blurred and the depressions were not obvious.There were no significant changes in the morphology of the affected radiuses.The lengths of the affected ulnas were measured，and one case was significantly shorter than that of the contralateral side.There were no significant differences in the lengths of the radiuses compared with the contralateral sides.Conclusion 3D-printed models can display the shapes of ulnar and radial deformities in children with chronic radial head dislocation，and guide the design of preoperative operation.

Key words： children ulnar and radial deformity chronic radial head dislocation 3D printing

基金资助:西安市卫生和计划生育委员会科研项目资助(J201702021)

通讯作者: 苗武胜

作者简介: 姜海(1975－ )，男，主任医师，西北妇女儿童医院骨科，710061。

引用本文:

姜海 1，李晓博 1，赵国龙 1，同毓龙 1，苗武胜 2*. 儿童陈旧性桡骨头脱位3D打印模型形态比较研究[J]. 实用骨科杂志, 2021, 27(1): 33-36.
Jiang Hai，Li Xiaobo，Zhao Guolong，et al. A Comparative Study of 3D-printed Models in Children with Chronic Dislocation of Radial Head. sygkzz, 2021, 27(1): 33-36.

链接本文:

http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2021/V27/I1/33

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