Abstract：Objective To investigate the application of the individual 3D printing guide plate in unilateral comminuted zygomatic complex fracture (ZCF) .Methods A retrospective analysis of the 37 cases with unilateral comminuted ZCF treated from June 2014 to December 2018 in Department of Oral and Maxillofacial Surgery of the Second Affiliated Hospital of Army Medical University was conducted. The patients were divided into the 3D guide plate group (n=20, treated with 3D printing guide plate) and the conventional group (n=17, treated with the traditional surgical method). Degree of mouth opening , postoperative complications and three dimension CT measurements(△L1: bilateral difference of linear distance between the orbitale point and superorbital rim point; △L2: bilateral difference of linear distance between malar process point and the mid-points of acoustic meatus; △L3: bilateral difference of linear distance between zygomatic point and the sagittal plane of the face;△α:bilateral difference between zygomatic angle;△β:bilateral difference between zygomatic arch angle) were compared between the two groups after operation .Results Postoperative three-dimensional CT measurements showed △L1,△L2,△L3,△α and △β were (1.04±0.62) mm vs (1.91±0.50)mm, (1.32±0.56) mm vs (3.50±0.92)mm,(1.48±0.64) mm vs (2.83±0.94) mm, 0.93°±0.34° vs 3.01°±0.56°, 0.97°±0.27° vs 2.73°±0.36° in the 3D guide plate group and the conventional group respectively,and the differences were statistically significant (all P value<0.01). Twenty patients in the 3D guide plate group had good facial symmetry. Three patients in the conventional group presented with symptoms of central collapse of the affected side.Conclusions The application of the individual 3D printing guide plate in the treatment of unilateral comminuted ZCF can improve the accuracy of fracture reduction.
季艳丹, 黄君杰, 夏超, 曾勇, 谭颖徽. 个性化3D打印导板在单侧粉碎性颧骨复合体骨折治疗中的应用价值[J]. 中华解剖与临床杂志, 2020, 25(3): 243-248.
Ji Yandan, Huang Junjie, Xia Chao, Zeng Yong, Tan Yinghui. Application of 3D printing guide plate in the treatment of unilateral comminuted zygomatic complex fractures. Chinese Journal of Anatomy and Clinics, 2020, 25(3): 243-248.
Strong EB, Gary C. Management of zygomaticomaxillary complex fractures[J]. Facial Plast Surg Clin North Am, 2017, 25(4): 547-562. DOI:10.1016/j.fsc.2017.06.006.
[2]
Olate S, Lima SM Jr, Sawazaki R, et al. Surgical approaches and fixation patterns in zygomatic complex fractures[J]. J Craniofac Surg, 2010, 21(4): 1213-1217. DOI:10.1097/SCS.0b013e3181e1b2b7.
Zingg M, Laedrach K, Chen J, et al. Classification and treatment of zygomatic fractures: a review of 1,025 cases[J]. J Oral Maxillofac Surg, 1992, 50(8): 778-790. DOI:10.1016/0278-2391(92)90266-3.
[5]
李林林, 季平, 李显, 等. 虚拟手术及3D打印导板在腓骨肌皮瓣修复下颌骨缺损中的临床应用[J]. 重庆医科大学学报, 2018, 43(10): 1349-1353.DOI:10.13406/j.cnki. cyxb.001664.Li LL, Ji P, Li X, et al. Clinical application of virtual surgery and 3D-printed plates in reconstruction of mandibular defects with fibula myocutaneous flap[J]. Journal of Chongqing Medical University, 2018, 43(10): 1349-1353. DOI:10.13406/j.cnki. cyxb.001664.
[6]
李富涛, 李焰, 马杰, 等. 计算机辅助虚拟手术设计结合3D打印技术在颌骨重建的应用研究[J]. 创伤外科杂志, 2017, 19(9): 657-661. DOI:10.3969/j.issn.1009-4237.2017.09.005.Li FT, Li Y, Ma J, et al. Application of combined use of computer-assisted virtual design and three-dimensional printing in reconstruction of mandibular bone[J]. Journal of Traumatic Surgery, 2017, 19(9): 657-661. DOI:10.3969/j.issn.1009-4237.2017.09.005.
[7]
Shilo D, Emodi O, Blanc O, et al. Printing the future-updates in 3D printing for surgical applications[J]. Rambam Maimonides Med J, 2018, 9(3): e20. DOI:10.5041/RMMJ.10343.
[8]
李铀, 曾勇, 吕俊, 等. 计算机辅助设计及3D打印模型在复杂下颌骨骨折手术中的应用[J]. 中华创伤杂志, 2018, 34(4): 299-304. DOI:10.3760/cma.j.issn.1001-8050.2018.04.003.Li Y, Zeng Y, Lyv J, et al. Application of computer-aided design and 3D printing model in operation for complex mandibular fractures[J]. Chin J Trauma, 2018, 34(4): 299-304. DOI:10.3760/cma.j.issn.1001-8050.2018.04.003.
[9]
吴健有, 刘静明, 陈志远, 等. 个体化数字导板在颧眶复合体骨折中的应用[J]. 北京口腔医学, 2011, 19(1): 31-34. DOI:10.3969/j.issn.1006-673X.2011.01.009.Wu JY, Liu JM, Chen ZY, et al. Application of individual digital reduction plate in the treatment of zygomatic-orbital complex fracture[J]. Beijing Journal of Stomatology, 2011, 19(1): 31-34. DOI:10.3969/j.issn.1006-673X.2011.01.009.
[10]
曾勇, 张纲, 雷涛, 等. Mimics软件在颧骨复合体骨折三维CT图像中的测量与应用[J]. 华西口腔医学杂志, 2012, 30(2): 123-127. DOI:10.3969/j.issn.1000-1182.2012.02.004.Zeng Y, Zhang G, Lei T, et al. Clinical application of Mimics software in three dimensional CT images for treatment of zygomatic complex fracture[J]. West China Journal of Stomatology, 2012, 30(2): 123-127. DOI:10.3969/j.issn.1000-1182.2012.02.004.
董智伟, 张新凤, 陈春艳, 等. 3D打印导板技术在单侧颧骨骨折治疗中的应用[J]. 解放军医药杂志, 2016, 28(11): 23-25. DOI:10.3969/j.issn.2095-140X.2016.11.007.Dong ZW, Zhang XF, Chen CY, et al. Three-dimensional printing guide in application of unilateral zygomatic bone Fracture[J]. Med ＆ Pharm J Chin PLA, 2016, 28(11): 23-25. DOI:10.3969/j.issn.2095-140X.2016.11.007.
[13]
袁晓燕, 龙洁. 数字化外科技术在颌面部外伤修复重建中的应用与展望[J]. 现代生物医学进展, 2016, 16(14): 2786-2788, 2792. DOI:10.13241/j.cnki.pmb.2016.14.048.Yuan XY, Long J. Application of digital surgery in maxillofacial traumatic reconstruction[J]. Progress in Modern Biomedicine, 2016, 16(14): 2786-2788, 2792. DOI:10.13241/j.cnki.pmb.2016.14.048.
[14]
He Y, Zhang Y, An JG, et al. Zygomatic surface marker-assisted surgical navigation: a new computer-assisted navigation method for accurate treatment of delayed zygomatic fractures[J]. J Oral Maxillofac Surg, 2013, 71(12): 2101-2114. DOI:10.1016/j.joms.2013.07.003.
[15]
Gong X, He Y, An J, et al. Application of a computer-assisted navigation system (CANS) in the delayed treatment of zygomatic fractures: a randomized controlled trial[J]. J Oral Maxillofac Surg, 2017, 75(7): 1450-1463. DOI:10.1016/j.joms.2016.10.001.
[16]
Yang C, Lee MC, Pan CH, et al. Application of computer-assisted navigation system in acute zygomatic fractures[J]. Ann Plast Surg, 2019, 82(1S Suppl 1): S53-S58. DOI:10.1097/SAP.0000000000001721.
[17]
Li JP, Chen SL, Zhang X, et al. Experimental research of accurate reduction of zygomatic-orbitomaxillary complex fractures with individual templates[J]. J Oral Maxillofac Surg, 2011, 69(6): 1718-1725. DOI:10.1016/j.joms.2010.09.006.
[18]
Gong X, He Y, He Y, et al. Quantitation of zygomatic complex symmetry using 3-dimensional computed tomography[J]. J Oral Maxillofac Surg, 2014, 72(10): 2051-2053. DOI:10.1016/j.joms.2014.06.447.
2020, Vol. 25 
