| 3D打印个性化肱骨远端表面置换假体的设计开发及临床应用初步探索 |
| Study on the design, development and preliminary clinical application of 3D-printed personalized distal humerus resurfacing prosthesis |
| 投稿时间：2025-10-27 |
| DOI：10.3969/j.issn.1672-5972.2026.04.016 |
| 中文关键词: 肱骨远端表面置换 个性化假体 3D打印 骨折畸形愈合 肱骨远端骨折 |
| 英文关键词:Distal humerus resurfacing arthroplasty Personalized prosthesis 3D printing Fracture malunion Distal humerus fracture |
| 基金项目:国家自然科学基金重点项目（82330076）；上海市卫生健康委员会新兴交叉领域研究专项（2022JC035）；上海市级医院诊疗技术推广及优化管理项目（SHDC22024305） |
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| 中文摘要: |
| 目的 针对现有肘关节假体应力集中、骨量去除大等问题，设计了一种3D打印个性化肱骨远端表面置换假体，并针对假体的设计、性能及临床应用进行分析。方法 基于肘关节影像数据，借助计算机辅助软件和3D打印技术开发了个性化肱骨远端表面置换假体。对假体的骨小梁结构进行了力学性能测试，采用体外模拟试验测试了肱骨远端关节面的骨保留量和匹配性，通过临床应用验证了该假体的可用性和初步有效性。结果 骨小梁结构的拉伸强度为（84.56±2.54）MPa，压缩强度为（108.31±1.38）MPa，弹性模量为（1.12±0.05）GPa。假体重建了肱骨远端解剖曲面，肱骨远端关节面的骨保留量达51%。临床应用案例证实了假体与尺桡骨近端匹配良好，患者肘关节活动恢复良好。结论 在肱骨远端复杂关节内骨折畸形愈合的治疗中，3D打印个性化肱骨远端表面置换假体可有效提高骨组织保留量，重建肱骨远端解剖结构，恢复肘关节自然运动特性。 |
| 英文摘要: |
| Objective To address the stress concentration and excessive bone resection in conventional elbow prostheses, a 3D-printed personalized distal humerus resurfacing prosthesis was developed, with analysis of its design, performance, and clinical application.Methods The personalized resurfacing prosthesis was developed using elbow imaging data, computer-aided design software, and 3D printing technology. Mechanical testing was performed to evaluate the properties of the trabecular structure. In vitro simulations were conducted to assess the bone preservation and anatomical compatibility of the articular surface. Clinical application was performed to validate the feasibility and preliminary effectiveness.Results The trabecular structure demonstrated mechanical properties with tensile strength of (84.56±2.54) MPa, compressive strength of (108.31±1.38) MPa, and elastic modulus of (1.12±0.05) GPa. The prosthesis reconstructed the anatomical curvature of the distal humerus with 51% native bone preservation. The clinical case confirmed optimal compatibility with the proximal ulna and radius, along with satisfactory restoration of elbow joint mobility.Conclusion For the treatment of complex intra-articular malunion of distal humerus, this 3D-printed personalized resurfacing prosthesis effectively improves bone preservation, reconstructs anatomical structures, and restores physiological elbow kinematics. |
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