传统手术与3D打印技术辅助手术治疗跟骨骨折的比较
Comparison of the Conventional Surgery and the Surgery Assisted by 3d Printing Technology in the Treatment of Calcaneal Fractures.
作者信息
Zheng Wenhao, Tao Zhenyu, Lou Yiting, Feng Zhenhua, Li Hang, Cheng Liang, Zhang Hui, Wang Jianshun, Guo Xiaoshan, Chen Hua
机构信息
a Department of Orthopaedic Surgery , The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University , Wenzhou , China.
出版信息
J Invest Surg. 2018 Dec;31(6):557-567. doi: 10.1080/08941939.2017.1363833. Epub 2017 Sep 19.
PURPOSE
This study was aimed to compare conventional surgery and surgery assisted by 3D printing technology in the treatment of calcaneal fractures. In addition, we also investigated the effect of 3D printing technology on the communication between doctors and patients.
METHODS
we enrolled 75 patients with calcaneal fracture from April 2014 to August 2016. They were divided randomly into two groups: 35 cases of 3D printing group, 40 cases of conventional group. The individual models were used to simulate the surgical procedures and carry out the surgery according to plan in 3D printing group. Operation duration, blood loss volume during the surgery, number of intraoperative fluoroscopy and fracture union time were recorded. The radiographic outcomes Böhler angle, Gissane angle, calcaneal width and calcaneal height and final functional outcomes including VAS and AOFAS score as well as the complications were also evaluated. Besides, we made a simple questionnaire to verify the effectiveness of the 3D-printed model for both doctors and patients.
RESULTS
The operation duration, blood loss volume and number of intraoperative fluoroscopy for 3D printing group was 71.4 ± 6.8 minutes, 226.1 ± 22.6 ml and 5.6 ± 1.9 times, and for conventional group was 91.3 ± 11.2 minutes, 288.7 ± 34.8 ml and 8.6 ± 2.7 times respectively. There was statistically significant difference between the conventional group and 3D printing group (p < 0.05). Additionally, 3D printing group achieved significantly better radiographic results than conventional group both postoperatively and at the final follow-up (p < 0.05). However, No significant difference was noted in the final functional outcomes between the two groups. As for complications, there was no significant difference between the two groups. Furthermore, the questionnaire showed that both doctors and patients exhibited high scores of overall satisfaction with the use of a 3D printing model.
CONCLUSION
This study suggested the clinical feasibility of 3D printing technology in treatment of calcaneal fractures.
目的
本研究旨在比较传统手术与3D打印技术辅助手术治疗跟骨骨折的效果。此外，我们还研究了3D打印技术对医患沟通的影响。
方法
我们纳入了2014年4月至2016年8月期间的75例跟骨骨折患者。他们被随机分为两组：3D打印组35例，传统组40例。3D打印组使用个体化模型模拟手术过程并按计划进行手术。记录手术时间、术中失血量、术中透视次数和骨折愈合时间。还评估了影像学结果，包括Böhler角、Gissane角、跟骨宽度和跟骨高度，以及最终功能结果，包括视觉模拟评分（VAS）和美国足踝外科协会（AOFAS）评分以及并发症。此外，我们制作了一份简单问卷，以验证3D打印模型对医生和患者的有效性。
结果
3D打印组的手术时间、失血量和术中透视次数分别为71.4±6.8分钟、226.1±22.6毫升和5.6±1.9次，传统组分别为91.3±11.2分钟、288.7±34.8毫升和8.6±2.7次。传统组与3D打印组之间存在统计学显著差异（p<0.05）。此外，3D打印组术后及最终随访时的影像学结果均明显优于传统组（p<0.05）。然而，两组的最终功能结果无显著差异。至于并发症，两组之间无显著差异。此外，问卷显示医生和患者对使用3D打印模型的总体满意度都很高。
结论
本研究表明3D打印技术治疗跟骨骨折具有临床可行性。
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