模块化截骨、角度测量装置的研制及在股骨颈基底部旋转截骨术中的初步应用

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摘要目的探讨3D打印截骨导向座、股骨头旋转角度测量器辅助行股骨颈基底部旋转截骨术在临床上的应用效果。方法自2019年6月至2022年6月，共有3例患者纳入研究，均为男性，右侧1例，左侧2例，年龄分别为48岁、31岁、41岁。术前计算患者股骨颈旋转轴线及股骨头坏死区域旋转角度等参数，结合逆向工程原理设计外科脱位及股骨颈基底部截骨导向座，并利用3D打印技术制作出截骨导向座。术中使用该导向座进行截骨，后借助自主研发股骨头旋转角度测量器精确旋转股骨头坏死区域。记录手术术中出血量、手术时长及术后并发症，术前、术后末次随访采用Harris髋关节评分对患侧髋关节进行功能评价。结果 3例患者均获随访，术后随访时间分别为24个月、20个月、35个月。术中出血量均为300 mL，手术时长分别为130 min、180 min、205 min。术前Harris评分为83分、74分、78分，末次随访Harris评分为94分、86分、83分。术后X线片示旋转程度及固定位置良好，均未见并发症发生。结论 3D打印截骨导向座联合旋转角度测量器有利于传统手术向可量化的、标准化的精确操作演化，为术者术中快速定位及精准截骨矫形提供了一种行之有效的新方法。

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	洪泽鑫
	陈亮
	陈景杨
	陈诚霖
	刘卓华
	马晨昊
	杨邵旭
	吴宇峰

关键词 ：股骨头坏死, 保髋手术, 3D打印技术, 截骨

Abstract：Objective To investigate the clinical effect of rotatory osteotomy at the base of femoral neck assisted by 3D printing osteotomy guide and femoral head rotation angle measuring device.Methods From June 2019 to June 2022，a total of 3 male patients were included in the study.One patient had a right-sided lesion，while two had left-sided lesions.Their ages were 48，31，and 41 years，respectively.Prior to surgery，the rotation axis of the femoral neck and the rotation angle of the necrotic area of the femoral head were precisely calculated.Based on the principles of reverse engineering，a customized surgical dislocation guide and basal femoral neck osteotomy template were designed.Intraoperatively，the necrotic area of the femoral head was rotated precisely using a self-developed femoral head rotation angle measuring device.The intraoperative blood loss，operation time，and any postoperative complications were carefully recorded.The hip function of each patient was evaluated using the Harris hip score both before surgery and at the final follow-up after surgery.Results The application of the 3D printing-guided osteotomy template and femoral head rotation angle measuring device resulted in successful rotatory osteotomy in all three patients.The follow-up durations were 24 months，20 months，and 35 months，respectively.Intraoperatively，the blood loss was 300 mL，and the operation times were 130 minutes，180 minutes，and 205 minutes.Preoperatively，the Harris hip scores were 83，74，and 78 points，respectively.At the final follow-up，the Harris hip scores had improved to 94 points，86 points，and 83 points.Postoperative X-ray images revealed excellent rotation and fixation positions，and no complications were observed.Conclusion The combined use of a 3D printed guide and a femoral head rotation angle measuring device has the potential to transform traditional orthopedic surgery into a more quantifiable and standardized precision operation.This approach offers surgeons an effective new method for rapid positioning and precise osteotomy，promising to enhance the overall clinical outcomes of orthopedic procedures.

Key words： femoral head necrosis hip preservation surgery 3D printing osteotomy

基金资助:中山市社会公益与基础研究项目(200404183452479)
实用新型专利：一种股骨颈截骨转头保髋手术装置(CN201920908473.X)
一种股骨头旋转角度测量器(CN201920908453.2)

通讯作者: 陈亮

作者简介: 洪泽鑫(1998－ )，男，研究生在读，广州中医药大学附属中山中医院骨三科，3479926869@qq.com

引用本文:

洪泽鑫，陈亮，陈景杨，陈诚霖，刘卓华，马晨昊，杨邵旭，吴宇峰. 模块化截骨、角度测量装置的研制及在股骨颈基底部旋转截骨术中的初步应用[J]. 实用骨科杂志, 2024, 30(5): 409-.
Hong Zexin，Chen Liang，Chen Jingyang，Chen Chenglin，Liu Zhuohua，Ma Chenhao，Yang Shaoxu，Wu Yufeng. The Development and Preliminary Application of a Modular Osteotomy and Angle Measurement Device for Rotational Osteotomy on the Base of Femoral Neck. sygkzz, 2024, 30(5): 409-.

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http://www.sygkzz.com/CN/ 或 http://www.sygkzz.com/CN/Y2024/V30/I5/409

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