Shi Weixiang, Luo Xiaozhong, Wu Gang, Ding Yong, Zhou Xin
Clinical Medical Academy of Southwest Medical University, Luzhou Sichuan, 646000, P.R.China.
Department of Orthopedics, the First Affiliated Hospital of Southwest Medical University, Luzhou Sichuan, 646000,
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Feb 15;32(2):187-191. doi: 10.7507/1002-1892.201710086.
To explore the effectiveness and advantage of three-dimensional (3D) printing technology in treatment of internal or external ankle distal avulsed fracture.
Between January 2015 and January 2017, 20 patients with distal avulsed fracture of internal or external ankle were treated with the 3D guidance of shape-blocking steel plate fixation (group A), and 18 patients were treated with traditional plaster external fixation (group B). There was no significant difference in gender, age, injury cause, disease duration, fracture side, and fracture type between 2 groups ( >0.05). Recording the fracture healing rate, fracture healing time, the time of starting to ankle functional exercise, residual ankle pain, and evaluating ankle function recovery of both groups by the American Orthopaedic Foot and Ankle Society (AOFAS) score.
All patients were followed up 8-24 months, with an average of 15.5 months. In group A: all incisions healed by first intention, the time of starting to ankle functional exercise was (14±3) days, fracture healing rate was 100%, and the fracture healing time was (10.15±2.00) weeks. At 6 months, the AOFAS score was 90.35±4.65. Among them, 13 patients were excellent and 7 patients were good. All patients had no post-operative incision infection, residual ankle pain, or dysfunction during the follow-up. In group B: the time of starting to ankle functional exercise was (40±10) days, the fracture healing rate was 94.44%, and the fracture healing time was (13.83±7.49) weeks. At 6 months, the AOFAS score was 79.28±34.28. Among them, 15 patients were good, 2 patients were medium, and 1 patient was poor. During the follow-up, 3 patients (16.67%) had pain of ankle joint with different degrees. There were significant differences in the postoperative fracture healing rate, fracture healing time, the time of starting to ankle functional exercise, and postoperative AOFAS score between 2 groups ( <0.05).
Application of 3D printing technology in treatment of internal or external ankle distal avulsed fracture is simple, safe, reliable, and effective. In particular, it is an ideal treatment for avulsed fracture.
探讨三维（3D）打印技术在治疗内外踝远端撕脱骨折中的有效性及优势。
2015年1月至2017年1月，20例内外踝远端撕脱骨折患者采用3D打印导向下形状记忆钢板内固定治疗（A组），18例患者采用传统石膏外固定治疗（B组）。两组患者在性别、年龄、致伤原因、病程、骨折侧别及骨折类型方面比较，差异均无统计学意义（P>0.05）。记录两组骨折愈合率、骨折愈合时间、开始踝关节功能锻炼时间、踝关节残留疼痛情况，并采用美国足踝外科协会（AOFAS）评分评估两组踝关节功能恢复情况。
所有患者均获随访8～24个月，平均15.5个月。A组：所有切口均一期愈合，开始踝关节功能锻炼时间为（14±3）天，骨折愈合率为100%，骨折愈合时间为（10.15±2.00）周。术后6个月AOFAS评分为90.35±4.65。其中优13例，良7例。随访期间所有患者均无切口感染、踝关节残留疼痛及功能障碍。B组：开始踝关节功能锻炼时间为（40±10）天，骨折愈合率为94.44%，骨折愈合时间为（13.83±7.49）周。术后6个月AOFAS评分为79.28±34.28。其中良15例，可2例，差1例。随访期间3例患者（16.67%）出现不同程度踝关节疼痛。两组术后骨折愈合率、骨折愈合时间、开始踝关节功能锻炼时间及术后AOFAS评分比较，差异均有统计学意义（P<0.05）。
3D打印技术应用于内外踝远端撕脱骨折的治疗，操作简单、安全可靠、疗效确切，尤其对于撕脱骨折是一种理想的治疗方法。
