目的：分析 3D 打印辅助聚甲基丙烯酸甲酯（PMMA）骨水泥髓内支撑在 Neer Ⅱ、Ⅲ、Ⅳ型肱骨近端骨质疏松性骨 折治疗中的应用。方法：回顾性分析 2021 年 10 月—2023 年 11 月在通用医疗汉中三二〇一医院接受 3D 打印辅助 PMMA 骨 水泥髓内支撑治疗的 90 例老年肱骨近端骨质疏松性骨折患者的临床资料，根据 Neer 分型将所有患者分为 Neer Ⅱ型骨折组 （n=28）、Neer Ⅲ型骨折组（n=37）和 Neer Ⅳ型骨折组（n=25），并观察患者的康复情况。结果：三组患者术前患侧颈干 角显著小于健侧颈干角（P<0.05），而术后 6 个月患侧颈干角与健侧颈干角比较，差异无统计学意义（P>0.05）。三组患者 术中与术后 6 个月的肱骨头高度差值均 <5 mm。三组患者术后不同时点的 VAS 评分和 Constant-Murley 评分均低于术前，差 异有统计学意义（P<0.05）；各组内不同时点评分两两比较，差异有统计学意义（P<0.05）。与术前相比，三组患者术后 6 个月的生活质量各维度评分明显升高，差异有统计学意义（P<0.05）。结论：对老年 Neer II、III、IV 型肱骨骨质疏松性骨 折患者行 3D 打印辅助 PMMA 骨水泥髓内支撑治疗能有效促进患者术后恢复，效果良好。

Objective: Analyze the application of 3D printing-assisted polymethylmethacrylate (PMMA) bone cemented intramedullary support in the treatment of Neer II, III, and IV osteoporotic fracture of the proximal humerus. Methods: 90 elderly patients with osteoporotic fractures of the proximal humerus who were treated with 3D printing-assisted PMMA bone cemented intramedullary support in General Healthcare Hanzhong 3201 Hospital from October 2021 to November 2023 were retrospectively selected and divided into the Neer II fracture group (n=28), the Neer III fracture group (n=37) and the Neer IV fracture group (n=25) according to the Neer classification, and the rehabilitation conditions of patients was observed. Results: The preoperative humeral neck-shaft angle of the affected side was all significantly smaller than that of the healthy side in the three groups (P<0.05), whereas the difference was not statistically significant at 6 months after surgery (P>0.05). The differences in humeral head height between intraoperative and postoperative 6-month measurements were all <5 mm in the three groups. VAS scores and Constant-Murley scores at different postoperative timepoints were all significantly lower than those befor surgery in the three groups (P<0.05), and the scores at different timepoints in pairwise comparisons showed significant differences (P<0.05). The scores on quality of life in all dimensions were significantly increased in the three groups at 6 months postoperatively compared with those before surgery (P<0.05). Conclusion: Application of 3D printing-assisted PMMA bone cement intramedullary support in treating elderly Neer type II, III, and IV osteoporotic fractures of the humerus can effectively promote the postoperative recovery and has a good application effect.

基金项目：陕西省重点研发计划项目（2019-SF-168） 

Foundation Item: Key R&D Plan Project of Shaanxi Province(2019-SF-168) 

引用格式：尹伟，于洋，宋永财，等 . 3D 打印辅助 PMMA 骨水泥髓内支撑在肱骨近端骨质疏松性骨折治疗中的应用 [J]. 机器人外科学杂志 （中英文），2025，6（3）：373-378. 

Citation: YIN W, YU Y, SONG Y C, et al. Application of 3D printing-assisted PMMA bone cement intramedullary support in the treatment  of osteoporotic fractures of the proximal humerus[J]. Chinese Journal of Robotic Surgery, 2025, 6(3): 373-378. 

通讯作者（Corresponding Author）：杨立峰（YANG Lifeng），Email：hunanylf@163.com

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