Department of Orthopaedics, Key Laboratory of Orthopaedics of Zhejiang Province, The Second School of Medicine of Wenzhou Medical University, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Department of Orthopaedics, Key Laboratory of Orthopaedics of Zhejiang Province, The Second School of Medicine of Wenzhou Medical University, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
J Orthop Sci. 2021 Jul;26(4):636-643. doi: 10.1016/j.jos.2020.06.008. Epub 2020 Aug 12.
Percutaneous reduction, cannulated screw fixation and calcium sulfate cement grafting (PR + CSC) for treatment of displaced and intra-articular calcaneal fractures (DIACFs) is a difficult technique, because the minimally invasive treatment has limited exposure and cannot be used to reduce articular surface under direct vision. The goal of this study was to apply 3D printing technology to preoperative planning and surgery of DIACFs, and to evaluate its effectiveness, feasibility and safety in fracture repair.
We enrolled 81 patients with DIACFs in the study from August 2015 to August 2017. Patients with DIACFs in our hospital were randomly divided into the 3D printing group (40 cases) and the conventional group (41 cases). The operation duration, blood loss volume and the number of fluoroscopy were compared. Radiological results were evaluated using radiographs and functional results were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) score. The complications were also assessed. In addition, we made a questionnaire to verify the usefulness of the 3D printed model for both doctors and patients.
The operation duration, blood loss volume and the number of fluoroscopy in 3D printing group were significantly less than that in the conventional group. Besides, 3D printing group achieved significantly better radiological results than conventional group both postoperatively and at the final follow-up except the calcaneal width at the final follow-up. The AOFAS score in the 3D printing group was significantly higher than that in the conventional group. In addition, the questionnaire from doctors and patients exhibited high scores of overall satisfaction of the 3D printed models. As for complications, there was no significant difference among the two groups.
This study suggested the clinical feasibility of PR + CSC assisted by 3D printing technology in the treatment of DIACFs.
II.
经皮复位、空心螺钉固定和硫酸钙水泥植骨（PR+CSC）治疗移位关节内跟骨骨折（DIACFs）是一种具有挑战性的技术，因为微创治疗的暴露有限，无法在直视下对关节面进行复位。本研究旨在将 3D 打印技术应用于 DIACFs 的术前规划和手术中，并评估其在骨折修复中的有效性、可行性和安全性。
我们纳入了 2015 年 8 月至 2017 年 8 月期间我院收治的 81 例 DIACFs 患者，采用随机数字表法将患者分为 3D 打印组（40 例）和常规组（41 例）。比较两组患者的手术时间、术中出血量和透视次数。采用 X 线片评估影像学结果，采用美国矫形足踝协会（AOFAS）评分评估功能结果。评估并发症。此外，我们制作了一份问卷，以验证 3D 打印模型对医生和患者的有用性。
3D 打印组的手术时间、术中出血量和透视次数均明显少于常规组。此外，3D 打印组术后和末次随访时的影像学结果均明显优于常规组，除末次随访时的跟骨宽度外。3D 打印组的 AOFAS 评分明显高于常规组。此外，医生和患者的问卷调查均显示 3D 打印模型的总体满意度评分较高。并发症方面，两组间无明显差异。
本研究表明 3D 打印技术辅助 PR+CSC 治疗 DIACFs 具有临床可行性。
II 级
