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目的:初步探讨3D打印技术辅助手术规划在儿童Gartland Ⅲ型肱骨髁上骨折手术治疗中的应用与效果。方法:在告知其法定监护人并遵循自愿原则的前提下，根据门、急诊X线片，选择2016年8月至2019年4月收治的新鲜闭合的Gartland Ⅲ型肱骨髁上骨折患儿40例参与本次研究。其中，男28例，女12例；年龄4～10岁，平均6.1岁；患侧位于左侧25例，右侧15例；手术距受伤时间48～72 h，平均57.8 h。采用随机数字表法，将40例患儿随机分成3D组和对照组，每组20例。其中，3D组患侧肘关节薄层CT扫描数据导入Accumed医学图像处理平台软件中进行骨折三维重建，用3D打印技术制作1∶1大小的肱骨髁上骨折实体模型，在实体模型上直接观察骨折移位情况，进行模拟骨折复位手术，选择最佳进针点及进针角度，并根据术前规划进行手术；对照组采用常规透视下闭合复位加克氏针固定。统计分析两组患儿围手术期一般情况，采用Kolmogorov-Smirnov正态性检验方法对数据进行正态分布性检验，采用两独立样本均数的n t检验比较分析术后两组患儿肱骨Baumann角及前倾角的差异，采用卡方检验比较分析术后4周Mayo肘关节功能评分(Mayo elbowperformance score，MEPS)的差异。n 结果:两组患儿年龄、受伤时间、骨折分型、术后Baumann角、前倾角测量结果比较，差异均无统计学意义(n P>0.05)。3D组手术时间为(58.50±11.25)min，术中透视次数为(6.85±1.23)次，术中透视时间为(13.70±3.79)min；对照组手术时间为(81.25±13.56)min，术中透视次数为(11.60±1.27)次，术中透视时间为(24.50±3.80)min。3D组在手术时间、术中透视次数和术中透视时间上均较对照组减少，且组间差异均有统计学意义(n P均0.05)。n 结论:3D打印技术从数字化设计转化出真实手术模型，并通过术前在模型实体上进行手术复位及进针点及进针角度术前设计，有助于实现对Gartland Ⅲ型肱骨髁上骨折进行个体化、精细化、微创化治疗。“,”Objective:To conduct a preliminary study on the application and effect of 3-dimensional printing assisted surgery planning in the treatment of Gartland type Ⅲ supracondylar humeral fracture in children.Methods:Under the principle of voluntary participation, a total of 40 hospitalized children with recently closed Gartland typeⅢ humeral supracondylar fractures from August 2016 to April 2019 were selected. They were randomly and equally divided into two groups of 3D reconstruction and control (n=20 each). There were 28 boys and 12 girls with an average age of 6.1(4-10) years. The involved side was left (n=25) and right (n=15). The average time from injury to surgery was 57.8(48-72) h. In 3D group, 3D computed tomography (CT) scan data of affected elbow joint were imported into Accumed medical image processing platform software for 3D reconstruction of fracture and 3D printing technology was utilized for establishing a 1∶1 suprahumeral fracture solid model. The displacement of fracture was observed on a solid model, simulated fracture reduction performed, optimal point and angle of needles selected and surgery proceeded according to the preoperative plan; control group was fixed with conventional reduction and Kirschner wire fixation under conventional fluoroscopy. Two groups were compared with regards to operative duration, number of intraoperative perspectives, Baumann angle, anteversion measurement and Mayo elbow function score at 4 weeks post-operation.Results:No statistically significant inter-group postoperative differences existed in age, injury time, fracture type, Baumann Angle or antegrade inclination (n P>0.05). In 3D group, operative duration was (58.50±11.25) min, number of intraoperative fluoroscopy (6.85±1.23) min and intraoperative fluoroscopy time (13.70±3.79) min. In control group, operative duration was (81.25±13.56) min, number of intraoperative fluoroscopy (11.60±1.27) min and intraoperative fluoroscopy time (24.50±3.80) min. Operative duration and frequency/duration of intraoperative fluoroscopy decreased in 3D group as compared with control group and the inter-group differences were statistically significant (n P0.05). However, the excellent rates of 3D and control groups were 95%(19/20) and 85%(17/20) respectively. There were no statistical differences.n Conclusions:3D printing technology transforms digital design into operative model. Through preoperative designs of surgical reduction, point or angle of insertion may be rehearsed on a model entity. It helps to realize individualized, refined and mini-invasive treatments of Gartland type Ⅲ supracondylar humeral fracture.