Department of Hand and Foot Surgery, Department of Orthropedics, Qilu Hospital of Shandong University, Jinan, P.R. China.
Comput Assist Surg (Abingdon). 2021 Dec;26(1):15-21. doi: 10.1080/24699322.2021.1887356.
Charcot neuroarthropathy of the ankle is an extremely challenging clinical dilemma, and its surgical management can be highly complicated. The goal of Charcot ankle treatment is to to restore a plantigrade and stable foot, and thus to avoid ulceration with subsequent infection. This report aims to introduce a method of correcting ankle deformity using a novel 3D printing technique.
One patient with Charcot ankle deformity was operated in this study. The ankle deformity of this patient was quantified in three dimensions through computed tomography. On the basis of the computed tomography scans, a new titanium implant was designed and manufactured using 3D printing. The implant was applied in the surgery of tibio-talo-calcaneal arthrodesis to restore local anatomy of the affected ankle of the patient with Charcot neuroarthropathy.
Evaluation of the post-operative radiography indicated union in the affected ankle. After surgery, the planar foot in this patient was restored. The patient was satisfied with the post-operative course, and joint fusion was successful as indicated by 2-year post-operative evaluation. The results of post-operative follow-up showed that the lower limb length of the patient with Charcot neuroarthropathy was salvaged, and the patient retained the plantigrade foot.
Three-dimensional printing technique combined with tibio-talo-calcaneal arthrodesis may help to correct ankle deformity in patients with Charcot neuroarthropathy.
踝关节夏科氏关节病是一个极具挑战性的临床难题，其手术治疗可能非常复杂。夏科氏足治疗的目标是恢复跖行足和稳定的足部，从而避免溃疡和随后的感染。本报告旨在介绍一种使用新型 3D 打印技术矫正踝关节畸形的方法。
本研究对 1 例夏科氏足畸形患者进行了手术。通过计算机断层扫描对该患者的踝关节畸形进行了三维量化。在此基础上，根据 CT 扫描设计并制造了新的钛植入物，该植入物用于跗骨-距跟关节融合术，以恢复夏科氏神经关节病患者受累踝关节的局部解剖结构。
术后影像学评估显示受累踝关节愈合。手术后，患者的平面足得到了恢复。患者对术后过程满意，2 年的术后评估显示关节融合成功。术后随访结果表明，夏科氏神经关节病患者的下肢长度得以挽救，患者保留了跖行足。
3D 打印技术结合跗骨-距跟关节融合术可能有助于矫正夏科氏神经关节病患者的踝关节畸形。
