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目的 探讨应用3D打印技术辅助髋臼周围截骨术治疗成人髋关节发育不良的可行性及疗效.方法 2015年7月至2016年5月,采用3D打印技术辅助髋臼周围截骨术治疗成人髋关节发育不良患者12例,男4例,女8例;年龄20～35岁,平均(27.4±4.4)岁.术前股骨头中心点垂线与髋臼外侧边缘夹角(Wigberg central edge angle,CE角)为9°～13°,平均11.1°±1.4°.首先应用3D技术个体化重建骨盆虚拟模型,通过软件确定最佳的髋臼周围弧形截骨线,设计与髋臼表面匹配的截骨导向模板;再应用3D打印技术打印骨盆模型及截骨导向模板,在骨盆模型上使用导向模板进行术前计划并模拟截骨矫形操作.经髋关节前外侧入路,行髂前上棘截骨暴露髋臼内壁,将截骨导向模板放置于髂前上棘与髂后上棘之间的切迹与四边体内侧面的远端之间,与骨盆内壁贴合,依据导向模板完成髋臼弧形截骨;再行耻骨截骨,参照术前计划对髋臼进行矫形,固定截骨块.记录手术时间、术中出血量及并发症发生情况.术后第1天复查髋关节正位X线片,测量CE角.结果 2例经3D打印的截骨导向模板在模拟操作后需修正,其余截骨导向模板在术中与患者骨盆内壁解剖结构均贴合良好.术后CE角增加至27°～3l°,平均29.3°±1.2°;手术时间1.5～3.0 h,平均(2.0±0.6)h;出血量480～1 000 ml,平均(640.0±180.8) ml.术中发生髋臼下方骨折1例,无骨盆后柱骨折和髋臼撞击发生.结论 对成人髋关节发育不良,3D打印技术辅助可使髋臼周围截骨更加直观、精确和简便,手术时间更短,出血量更少.“,”Objective To explore the feasibility and efficacy of three-dimensional (3D) printing technique aided periacetabular osteotomy for adult developmental dysplasia of the hip (DDH).Methods Twelve adult patients (4 males and 8 females) with an average age of 27.4±4.4 (range from 20 to 35) years old were diagnosed as DDH in our hospital and were treated with 3D printing technique aided periacetabular osteotomy from July 2015 to May 2016.The preoperative average Wiberg centraledge angle was 11.1 °± 1.4° (range from 9° to 13°).The 3D printing technique was used to virtually reconstruct the patient-specific pelvis before the optimal periacetabular cutting line was designed and reconstructed into an osteotomy guiding template virtually.Afterwards,the patient-specific pelvic model and the guiding template were fabricated by 3D printing.Simulating practice on the patient-specific pelvic model was performed with the template in accordance with the preoperative plan.During the surgery,an anterolateral approach to the hip joint was adopted followed by the anterior osteotomy of superior iliac spine and the exposure of medial wall of the acetabulum,and 3D printed guiding template was placed from the incisura between anterior superior iliac spine and anterior inferior iliac spine to the distal part of the medial wall of quadrilateral surface.The template should fit the medial wall of pelvis well to facilitate the following curved periacetabular osteotomy and the pubis osteotomy.The osteotomized acetabular fragment was repositioned and fixed according to plan.The surgical time,blood loss (intra-and post-operatively) and complications were recorded.The patients underwent anterior-posterior X-ray of the hip joint to measure the CE angle the day after surgery.Results All the guiding templates fitted the anatomical structure of the corresponding patients pretty well except two templates needed to be modified after practice.The average Wiberg central-edge angle increased to 29.3°±1.2° (range from 27° to 31°) postoperatively.The average surgical time was 2.0±0.6 h (range from 1.5 to 3.0 h) and the average blood loss was 640.0± 180.8 ml (range from 480 to 1 000 ml).There was no pelvis posterior column fracture or acetabular impingement except one fracture occurred at the inferior part of acetabulum.Conclusion 3D printing technique resulted in a more intuitive,accurate and convenient periacetabular osteotomy with the shortened surgical time and reduced blood loss in treating adult DDH.