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| Advantages of 3D printing simulation surgery method in the proximal humeral Neer four-part fractures and its influence on postoperative functional recovery |
| DAI Feng1 WANG Qing2 WANG Jiang1 FAN Zhihao1 JIANG Zhengyu1 |
1.Department of Orthopedics, Liyang Branch, Jiangsu Provincial People’s Hospital, Jiangsu Province, Liyang 213300, China;
2.Department of Joint Surgery, Jiangsu Provincial People’s Hospital, Jiangsu Province, Liyang 210029, China |
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Abstract Objective To explore the advantages of 3D printing simulation surgery method in the proximal humeral Neer four-part fractures and the effect of postoperative function recovery. Methods A total of 60 patients with proximal humeral Neer four-part fractures who were admitted to Liyang Branch, Jiangsu Provincial People’s Hospital from January 2017 to January 2020 were selected and divided into 3D group and traditional group by random number table method, with 30 patients in each group. Both groups were treated with locking plate combined with minimally invasive plate osteosynthesis, and the 3D group was treated with three-dimensional reconstruction to establish 3D printing model. After simulating the implementation of surgical engineering, the patients were operated according to the plan. Operative time, amount of surgical bleeding, number of intraoperative C-arm fluoroscopy, anatomic reduction rate, fracture healing time, shoulder joint function of patients at postoperative difference time (Constant-Murley score) and surgical complications were compared between the two groups. Results Operative time, amount of surgical bleeding, number of intraoperative C-arm fluoroscopy and fracture healing time in the 3D group were all lower than those in the traditional group, with statistically significant differences (all P ＜ 0.05). The anatomic reduction rate of the 3D group was higher than that of the traditional group, and the difference was statistically significant (P ＜ 0.05). Six months after the surgery, pain, muscle strength, daily activity, range of joint activity and Constant-Murley total score were all increased in the two groups compared with the three months after the surgery, and the differences were statistically significant (all P ＜ 0.05). Three months after the surgery, pain, muscle strength, daily activity, range of joint activity and Constant-Murley total score in the 3D group were all higher than those in the traditional group, with statistically significant differences (all P ＜ 0.05). Six months after the surgery, pain, muscle strength, daily activity, range of joint activity and Constant-Murley total score in the 3D group were not significantly different from those in the traditional group (all P ＞ 0.05). The incidence rate of surgical complications of the 3D group was lower than that of the traditional group, and the difference was statistically significant (P ＜ 0.05). Conclusion The application of 3D printing simulation surgery method in the proximal humeral Neer four-part fractures has certain advantages in shortening the operation time, reducing the surgical bleeding, improving the reduction effect, and improving the early recovery of shoulder joint function after the surgery.
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