3D printing the affected hand model to guide the individualized selection of flap in the treatment of contracture of the first web space

Guo Liping, Ju Jihui, Zhou Rong, Wang Jian, Yu Xinshui

Chinese Journal of Clinical Anatomy ›› 2022, Vol. 40 ›› Issue (2) : 221-224.

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Chinese Journal of Clinical Anatomy ›› 2022, Vol. 40 ›› Issue (2) : 221-224. DOI: 10.13418/j.issn.1001-165x.2022.2.19

3D printing the affected hand model to guide the individualized selection of flap in the treatment of contracture of the first web space

  • Guo Liping, Ju Jihui*, Zhou Rong,Wang Jian,Yu Xinshui
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Abstract

Objective To investigate the clinical application of individualized skin flap in the treatment of contracture of first web space by 3D printing the model of the affected hand. Methods From March 2018 to October 2019, 10 cases of moderate and severe contracture of first web space were treated with 3D printing of the affected hand model before operation. The appropriate flaps were selected to repair the wound individualized according to the shape and area of the wound after opening the first web space of the model. Intraoperative comparison and verification, postoperative follow-up were performed to observe the treatment effect. Results The shape and area of the wound and the flap selection were basically in accordance with that of the preoperative simulation design. All the 10 cases of flaps survived, and the donor and recipient wound were healed at I stage.  All flaps were followed up for 6~12 months. The appearance of the flaps was satisfactory, the sensation was partial recovered the abduction and opposition function of the thumb were restored. The angle of first web space increased by 50°-60°(with an average of 53.4°), and the width increased by 18mm-35 mm (with an average of 31.3 mm). The repair evaluation of the first web space were excellent in 7 cases, good in 2 cases, medium in1 case. Conclusions The 3D printing of the affected hand model before operation can guide the individualized skin flap, so that the enlarged wound with contracture can be repaired accurately, the operation time can be reduced, and the shape and function of the first web space can be recovered well after operation.

Key words

3D printing /  Contracture of the first web space /  Flap /   Individualized

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Guo Liping, Ju Jihui, Zhou Rong, Wang Jian, Yu Xinshui. 3D printing the affected hand model to guide the individualized selection of flap in the treatment of contracture of the first web space[J]. Chinese Journal of Clinical Anatomy. 2022, 40(2): 221-224 https://doi.org/10.13418/j.issn.1001-165x.2022.2.19

References

[1]  路来金, 宫旭, 余新, 等. 虎口挛缩的皮瓣修复[J]. 中华显微外科杂志, 2010, 33(2): 110-111. DOI: 10.3760/cma.j.issn.1001-2036.2010.02.009.
[2]  郑大伟, 黎章灿, 石荣剑, 等. 腕横纹逆行岛状皮瓣修复虎口瘢痕挛缩16例[J]. 中华显微外科杂志, 2019, 42(2): 170-172. DOI: 10.3760/cma.j.issn.1001-2036.2019.02.017.
[3]  俞淼, 史增元, 尹维刚, 等. 虎口区背侧逆行岛状皮瓣的应用解剖[J]. 中国临床解剖学杂志, 2009, 27(5): 520-522. DOI: CNKI: SUN:ZLJZ.0.2009-05-007.
[4]  姚建民, 徐靖宏, 谢庆平, 等. 四肢精准显微外科: 认知艺术化和技术人文化[J]. 中华显微外科杂志, 2015, 38(4): 313-315. DOI: 10.3760/cma.j.issn.1001-2036.2015.04.001.
[5]  Jensen CB, Rayan GM, Davidson R. First web space contracture and hand function[J]. J Hand Surg Am, 1993, 18(3): 516-520. DOI: 10.1016/0363-5023(93)90103-A.
[6]  顾玉东, 吴敏明, 郑忆柳, 等. 虎口挛缩的病因、预防及治疗[J]. 中华骨科杂志,1986,6(1):1-3.DOI:10.3760/cma.j.issn.0253-2352.1986.01.101.
[7]  刘小俊, 王志学, 苏建东, 等. 股前外侧薄皮瓣在修复重建外科的应用进展[J]. 中国临床解剖学杂志, 2019, 37(1): 110-112. DOI: 10.13418/j.issn.1001-165x.2019.01.023.
[8]  张楠, 史增元, 尹维刚, 等. 第1掌背动脉逆行岛状皮瓣的应用解剖学[J]. 中国临床解剖学杂志, 2012, 30(3): 264-267.
[9]  侯书健, 程国良, 方光荣, 等. 外伤性拇指指蹼挛缩的I临床分型与治疗[J]. 中华手外科杂志, 2001, 17(z1): 4-6. DOI: 10.3760/cma.j.issn.1005-054X.2001.z1.002.
[10]王光华, 卫伟. 手瘢痕挛缩畸形整形疗效分析[J]. 中国美容医学, 2017, 26(2): 26-28. DOI: 1008-6455(2017)02-0026-02.
[11]汤样华, 曾林如, 胡中青, 等. 穿支皮瓣移植修复虎口皮肤软组织缺损35例[J]. 中华创伤杂志, 2017, 33(9): 834-837. DOI: 10.3760/cma.j.issn.1001-8050.2017.09.011.
[12] 陈彦名, 唐举玉, 谢松林, 等. 腓肠内侧动脉穿支皮瓣游离移植修复重度虎口瘢痕挛缩[J]. 中华手外科杂志, 2017, 33(3): 190-192. DOI: 10.3760/cma.j.issn.1005-054X.2017.03.013.
[13] 魏诚, 巨积辉, 金乾衡, 等. 第一掌背动脉岛状皮瓣修复虎口瘢痕挛缩[J]. 中华手外科杂志, 2018, 34(2): 141-142. DOI: 10.3760/cma.j.issn.1005-054X.2018.02.023.
[14] 熊胜, 巨积辉, 金光哲, 等. 彩超定位下游离腓浅动脉穿支皮瓣修复手足部创面[J]. 中华手外科杂志, 2018, 34(6): 418-420. DOI: 10.3760/cma.j.issn.1005-054X.2018.06.007.
[15] 黄显华, 夏远军, 章莹, 等. 股前外侧皮瓣修复拇指虎口及邻近组织毁损伤[J]. 中国骨科临床与基础研究杂志, 2019, 11(2): 104-108. DOI: 10.3969/j.issn.1674-666X.2019.02.007.
[16] 熊胜, 巨积辉, 金光哲, 等. 游离同侧多块小腿腓浅动脉穿支皮瓣修复手部多发创面效果观察[J]. 中华烧伤杂志, 2019, 35(9): 655-660. DOI: 10.3760/cma.j.issn.1009-2587.2019.09.003.
[17] 邓伟, 巨积辉, 李雷, 等. 血流桥接型股前外侧皮瓣修复下肢主干血管及软组织缺损创面[J]. 中国临床解剖学杂志, 2017, 35(6): 676-680. DOI: 10.13418/j.issn.1001-165x.2017.06.017.
[18] Qiu B, Liu F, Tang B, et al. Clinical study of 3D imaging and 3D printing technique for patient- specific instrumentation in total knee a-rthroplasty[J]. J Knee Surg, 2017, 30(8): 822-828. DOI: 10.1055/s-0036-1597980.
[19] 刘刚. 3D打印技术在复杂创伤骨科教学中的应用[J]. 课程教育研究, 2018, (47): 229. DOI: 2095-3089(2018)47-0223-01.
[20] 刘军, 黎逢峰, 吴永伟, 等. 膝降动脉作为游离股前外侧皮瓣受区血管的临床应用[J]. 中国临床解剖学杂志, 2018, 36(4): 426-429. DOI: CNKI:SUN:ZLJZ.0.2018-04-016.
[21] 李文鹿, 乔永明, 李锐, 等. 数字化与3D打印技术辅助腓骨皮瓣修复重建上颌骨缺损八例[J]. 中华显微外科杂志, 2018, 41(3): 273-275. DOI: 10.3760/cma.j.issn.1001-2036.2018.03.020.
[22] Gellman H, Botte MJ, Shankwiler J, et a1. Arterial patterns of the deep and superficial palmar arches[J]. Clin Orthop Relat Res, 2001, 383: 41-46. DOI: 10.1097/00003086-200102000-00007.
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