THE USE OF A TRAINING 3D-MODEL IN THE TREATMENT OF A PATIENT WITH A PATHOLOGICAL FRACTURE OF THE PROXIMAL PART OF THE FEMUR (CASE FROM PRACTICE)

Oleg Drobotun, Sergii Konovalenko, Mykola Ternovyi
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Abstract

Prostate cancer is the second most common cause of malignancy in men, with bone metastases being a significant source of morbidity and mortality in advanced cases. Objective. To give a clinical example of a patient with a pathological transtrochanteric fracture of the right femur with displacement of fragments, the presence of metastasis at the fracture site, to emphasize the importance of 3D-training before surgery. Methods. A clinical example with a significant impairment of the function of the right lower extremity against the background of a significant pain syndrome is given. The diagnosis was established: pathological transtrochanteric fracture of the right femur with displacement of fragments, the presence of metastasis at the fracture site. Pre-surgical training was carried out using a 3D-model and total endoprosthetics of the right hip joint with a revision individual implant of the cement fixation type was carried out. The patient fully recovered the function of the right lower limb and hip joint, the pain syndrome was eliminated, and sleep normalized. The use of a 3D-model for preoperative training of surgeons made it possible to rationally limit traumatization of healthy tissues during tumor removal, prevent possible complications and optimize the time of surgical intervention and thus minimize blood loss. Conclusions. The use of a training 3D-model before surgery followed by prosthetics with a special oncological endoprosthesis provided satisfactory functional results and restoration of the patient's quality of life in the given clinical case. The use of a 3D-model is the key to careful preparation for surgical intervention, taking into account the individual anatomical features of the pathological process and adjacent tissues, which allows you to significantly optimize the terms of the operation and reduce blood loss, and also provides valuable experience for further surgical practice.
在治疗股骨近端病理性骨折患者时使用训练用 3D 模型(实践案例)
前列腺癌是男性第二大常见恶性肿瘤,骨转移是晚期病例发病和死亡的重要原因。目的。举例说明一名右股骨病理性经转子间骨折患者的临床表现,该骨折伴有骨片移位,骨折部位存在骨转移,强调术前三维培训的重要性。方法。举例说明在明显疼痛综合征的背景下右下肢功能明显受损的临床病例。诊断确定:右股骨病理性经转子间骨折,骨折碎片移位,骨折部位存在转移灶。使用三维模型进行了术前培训,并进行了右髋关节全内固定术和翻修性骨水泥固定型单个假体植入术。患者的右下肢和髋关节功能完全恢复,疼痛综合征消失,睡眠正常。利用三维模型对外科医生进行术前培训,可以合理地限制肿瘤切除过程中对健康组织的创伤,预防可能出现的并发症,优化手术时间,从而最大限度地减少失血量。结论在该临床病例中,术前使用三维模型进行训练,然后使用特殊的肿瘤内假体进行修复,取得了令人满意的功能效果,恢复了患者的生活质量。考虑到病理过程和邻近组织的个体解剖学特征,使用三维模型是精心准备手术干预的关键,这样可以大大优化手术条件,减少失血量,还能为进一步的手术实践提供宝贵的经验。
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