虚拟手术结合导板辅助7例髁突颈部骨折复位固定的效果评价

目的 ：探讨数字化虚拟手术、3D打印模型结合导板在下颌骨髁突颈部骨折手术中的临床应用效果。方法 ：选择7例下颌髁突颈部骨折患者，行1.0 mm层厚三维CT扫描，数据通过DICOM格式导出，利用软件进行虚拟手术复位骨折，复位后3D打印出下颌骨模型。将钛板预弯曲固定，并在下颌骨模型上制作复位及钻孔导板，指导手术过程中骨折的精准复位和固定。结果：术后手术切口均无感染，创口隐蔽美观，骨折对位精确，钛板与骨折段贴合。术后随访，髁突颈部骨折愈合良好，髁突位于关节窝内。患者咬合关系良好，开口受限不明显，无开口疼痛、咬合疼痛等颞下颌关节疾病体征。结论：虚拟手术、3D打印模型结合导板能让髁突颈部骨折精确复位，简化手术过程，是一种精准、高效、可预测的手术辅助方式。

Clinical application of virtual surgery combined with guide plate in reduction and fixation of condylar neck fracture in 7 patients

PURPOSE: To explore the value of virtual surgery and 3D printing model combined with guide plate in treatment of mandibular condylar neck fracture. METHODS: Seven patients with mandibular condylar neck fracture were scanned by CT for original data. The data were exported in DICOM format. A three-dimensional model was reconstructed using software, the fracture was reduced by virtual surgery, and the 3D model was printed by a 3D printer. A prebent titanium plate was used to fabricate the guide plate, which was used for reduction and fixation of the fracture block during surgery. RESULTS: All the postoperative incisions revealed no signs of infection, the wounds were hidden and beautiful. The implanted titanium plates were highly compatible with the reduced fracture segments. The patients were followed up for 6 months after surgery, the condylar fracture healed well and there was no obvious displacement. The patient developed no mandibular deviation with a stable occlusion, and no occlusal pain was reported. No obvious temporomandibular joint disorder was present. CONCLUSIONS: Virtual surgery and 3D printing model combined with guide plate can ensure an accurate reduction of condylar neck fracture and simplify the operation process, which can be used as an accurate, efficient and predictable auxiliary method.