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Abstract：
OBJECTIVE: To explore the application of individualized transiliac crest nail-grafting guide plate prepared by computer-aided design and three-dimensional (3D) printing technology in deep pelvic external fixator implantation.
METHODS: Five patients with pelvic fractures were collected between May 2017 and February 2018. There were 4 females and 1 male with an average age of 52 years (range, 29-68 years). Pelvic fractures were classified as type B in 3 cases and type C in 2 cases by Tile classification. The interval between injury and operation was 6-14 days (mean, 9 days). The preoperative CT images of pelvic fractures were collected. The data was reconstructed by 3D imaging reconstruction workstation. An individualized transiliac crest nail-grafting guide plate was designed on the virtual 3D model. The individualized transiliac crest nail-grafting guide plate and the solid pelvic model were produced with the 3D printing technology. The individualized transiliac crest nail-grafting guide plate was used for intraoperative deep pin position on iliac crest after the preoperative simulation. The follow-up CT scans were used to determine the differences in distance from anterior superior iliac spine, convergence angle, and caudal angle between the preoperative plan and postoperative measurement.
RESULTS: During the operation, the individualized transiliac crest nail-grafting guide plate was used to guide the placement of 20 pins. X-ray film and CT examination showed that all pins were well positioned. The average depth of pins was 83.16 mm (range, 70.13-100.53 mm). Fitted 3D reconstruction images showed that the entry point and orientation of the pins were all consistent with preoperative schemes. Compared with the planned nail path, there was no significant difference in the distance from anterior superior iliac spine, convergence angle, and caudal angle in the actual nail path ( P>0.05). No loosening and rupture of pin, no damage of blood vessels and nerve, and shallow or deep infection occurred during 3 months follow-up, and the incisions healed by first intention. All patients were satisfied with the treatment process. The ranges of motion of hip and knee were normal, and the visual analogue scale (VAS) score was 0-3 (mean, 0.5).
CONCLUSIONS: The individualized transiliac crest nail-grafting guide plate technique is the improvement of traditional technique. It can increase accuracy and effective depth of pin position, enable patients to obtain pelvic mechanical stability quickly after operation, and reduce the risk of complications related to nail path.
UNASSIGNED: 探讨利用计算机辅助设计和 3D 打印技术制备的个体化经髂嵴植钉导板在骨盆外固定架深部植钉中的应用。.
UNASSIGNED: 2017 年 5 月—2018 年 2 月，收治 5 例骨盆骨折患者。男 1 例，女 4 例；年龄 29～68 岁，平均 52 岁。骨盆骨折 Tile 分型 B 型 3 例，C 型 2 例。受伤至手术时间 6～14 d，平均 9 d。依据术前 CT 扫描数据三维重建骨盆，并设计个体化经髂嵴植钉导板，利用 3D 打印技术制备骨盆模型及导板；术前模拟植钉过程后，术中在个体化经髂嵴植钉导板辅助下植入外固定钉。术后复查 CT，依据手术前后三维图像，测量实际钉道和规划钉道起始端与髂前上棘骨性凸起顶部的距离，分别在横断面和冠状面上测量规划钉道和实际钉道的内倾角及尾倾角。.
UNASSIGNED: 所有患者术中均应用个体化经髂嵴植钉导板辅助成功植钉，共植入 20 枚外固定钉，均为单次植入。X 线片和 CT 检查显示所有外固定钉位置良好，植入长度 70.13～100.53 mm，平均 83.16 mm。拟合后的三维重建图像显示所有外固定钉的进钉点、钉道方向均与术前规划一致。和规划钉道比较，实际钉道与髂前上棘的距离、内倾角、尾倾角差异均无统计学意义（ P>0.05）。术后随访 3 个月，所有外固定钉均未发生松动、断裂；均未发生血管、神经损伤，浅表和深部组织感染，切口均Ⅰ期愈合。所有患者对治疗过程满意，髋、膝关节活动度正常，末次随访时疼痛视觉模拟评分（VAS）为 0～3 分，平均 0.5 分。.
UNASSIGNED: 个体化经髂嵴植钉导板辅助植钉技术是对传统经髂嵴植钉技术的改良，可提高外固定钉植入精确度和有效延长钉道长度，使患者术后迅速获得骨盆力学稳定性、降低钉道相关并发症风险。.
METHODS: Five patients with pelvic fractures were collected between May 2017 and February 2018. There were 4 females and 1 male with an average age of 52 years (range, 29-68 years). Pelvic fractures were classified as type B in 3 cases and type C in 2 cases by Tile classification. The interval between injury and operation was 6-14 days (mean, 9 days). The preoperative CT images of pelvic fractures were collected. The data was reconstructed by 3D imaging reconstruction workstation. An individualized transiliac crest nail-grafting guide plate was designed on the virtual 3D model. The individualized transiliac crest nail-grafting guide plate and the solid pelvic model were produced with the 3D printing technology. The individualized transiliac crest nail-grafting guide plate was used for intraoperative deep pin position on iliac crest after the preoperative simulation. The follow-up CT scans were used to determine the differences in distance from anterior superior iliac spine, convergence angle, and caudal angle between the preoperative plan and postoperative measurement.
RESULTS: During the operation, the individualized transiliac crest nail-grafting guide plate was used to guide the placement of 20 pins. X-ray film and CT examination showed that all pins were well positioned. The average depth of pins was 83.16 mm (range, 70.13-100.53 mm). Fitted 3D reconstruction images showed that the entry point and orientation of the pins were all consistent with preoperative schemes. Compared with the planned nail path, there was no significant difference in the distance from anterior superior iliac spine, convergence angle, and caudal angle in the actual nail path ( P>0.05). No loosening and rupture of pin, no damage of blood vessels and nerve, and shallow or deep infection occurred during 3 months follow-up, and the incisions healed by first intention. All patients were satisfied with the treatment process. The ranges of motion of hip and knee were normal, and the visual analogue scale (VAS) score was 0-3 (mean, 0.5).
CONCLUSIONS: The individualized transiliac crest nail-grafting guide plate technique is the improvement of traditional technique. It can increase accuracy and effective depth of pin position, enable patients to obtain pelvic mechanical stability quickly after operation, and reduce the risk of complications related to nail path.
UNASSIGNED: 探讨利用计算机辅助设计和 3D 打印技术制备的个体化经髂嵴植钉导板在骨盆外固定架深部植钉中的应用。.
UNASSIGNED: 2017 年 5 月—2018 年 2 月，收治 5 例骨盆骨折患者。男 1 例，女 4 例；年龄 29～68 岁，平均 52 岁。骨盆骨折 Tile 分型 B 型 3 例，C 型 2 例。受伤至手术时间 6～14 d，平均 9 d。依据术前 CT 扫描数据三维重建骨盆，并设计个体化经髂嵴植钉导板，利用 3D 打印技术制备骨盆模型及导板；术前模拟植钉过程后，术中在个体化经髂嵴植钉导板辅助下植入外固定钉。术后复查 CT，依据手术前后三维图像，测量实际钉道和规划钉道起始端与髂前上棘骨性凸起顶部的距离，分别在横断面和冠状面上测量规划钉道和实际钉道的内倾角及尾倾角。.
UNASSIGNED: 所有患者术中均应用个体化经髂嵴植钉导板辅助成功植钉，共植入 20 枚外固定钉，均为单次植入。X 线片和 CT 检查显示所有外固定钉位置良好，植入长度 70.13～100.53 mm，平均 83.16 mm。拟合后的三维重建图像显示所有外固定钉的进钉点、钉道方向均与术前规划一致。和规划钉道比较，实际钉道与髂前上棘的距离、内倾角、尾倾角差异均无统计学意义（ P>0.05）。术后随访 3 个月，所有外固定钉均未发生松动、断裂；均未发生血管、神经损伤，浅表和深部组织感染，切口均Ⅰ期愈合。所有患者对治疗过程满意，髋、膝关节活动度正常，末次随访时疼痛视觉模拟评分（VAS）为 0～3 分，平均 0.5 分。.
UNASSIGNED: 个体化经髂嵴植钉导板辅助植钉技术是对传统经髂嵴植钉技术的改良，可提高外固定钉植入精确度和有效延长钉道长度，使患者术后迅速获得骨盆力学稳定性、降低钉道相关并发症风险。.
摘要：
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