3D打印量化植骨辅助自体髂骨植骨联合锁定钢板内固定在老年肱骨近端粉碎性骨折中的疗效分析

Efficacy analysis of 3D-printed quantitative bone grafting assisted autologous iliac bone grafting combined with locking plate internal fixation in comminuted proximal humerus fractures in the elderly

摘要:

目的 探讨3D打印量化植骨辅助自体髂骨植骨联合锁定钢板（LCP）内固定在老年肱骨近端粉碎性骨折中的临床疗效。方法 选取2022年7月—2024年2月宝鸡高新医院收治的130例老年肱骨近端粉碎性骨折患者为研究对象。根据治疗方法的差异分为对照组与研究组。对照组采用自体髂骨植骨联合LCP内固定治疗；研究组在对照组基础上采用3D打印量化植骨辅助治疗。所有患者随访12个月，对比两组手术相关指标，比较两组患者术后6、12个月的肩关节功能、骨密度及生活质量，并记录随访期间并发症发生情况。结果 研究组较对照组出血量少，术后1 h疼痛评分低，手术时间、住院时间及骨折愈合时间均更短（P <0.05）。术后12个月两组的Constant-Murley评分、骨密度T值及SF-36评分均较术后6个月高（P <0.05）。研究组术后6、12个月的Constant-Murley评分、骨密度T值及SF-36评分均高于对照组（P <0.05）。研究组并发症总发生率低于对照组（P <0.05）。与对照组比较，研究组住院总费用和并发症处理费用均更低（P <0.05）。结论 在3D打印量化植骨技术的辅助下，对老年肱骨近端粉碎性骨折患者行自体髂骨植骨联合LCP内固定术可显著缩短手术时间，患者骨愈合更快、肩功能恢复更好，并降低并发症发生率。

Abstract:

Objective To investigate the clinical efficacy of 3D-printed quantitative bone grafting assisted autologous iliac bone grafting combined with locking compression plate (LCP) internal fixation in comminuted proximal humerus fractures in the elderly.Methods One hundred and thirty elderly patients with comminuted proximal humerus fractures admitted to Baoji High-tech Hospital between July 2022 and February 2024 were selected. They were divided into a control group (treated with autologous iliac bone grafting combined with LCP internal fixation) and a study group (3D printing quantitative bone grafting was used to assist the treatment on the basis of the control group). After 12 months of follow-up, the two groups were compared in terms of surgery-related indexes, shoulder joint function, bone density, quality of life, and the occurrence of complications.Results Compared with the control group, the study group had less bleeding, lower pain score at 1 hour post-operation, shorter operation time, shorter hospitalization time, and shorter fracture healing time (P < 0.05). The Constant-Murley score, bone mineral density T value, and SF-36 score in the study group were higher than those in the control group at 6 and 12 months after operation (P < 0.05). The incidence of total complications in the study group was lower than that in the control group (P < 0.05). The total hospitalization expenses and complications treatment costs of the study group were lower than those of the control group (P < 0.05).Conclusion With the assistance of 3D printing quantitative bone grafting technology, autologous iliac bone grafting combined with LCP internal fixation in elderly patients with comminuted proximal humerus fracture can significantly shorten the operation time, promote faster bone healing and better recovery of shoulder function, and significantly reduce the occurrence of complications.