Zheng Hongming, Xia Yan, Ni Xiaohui, Wu Jieshi, Li Yankun, Zhang Pengpeng, Wu Xinglin, Lu Kaihang, Zhao Quanming
Department of Orthopedic Surgery, Affiliated Danyang Hospital of Nantong University, Danyang, China.
Department of Orthopedics, Dafeng People's Hospital, Yancheng, China.
Front Surg. 2023 May 24;10:1176254. doi: 10.3389/fsurg.2023.1176254. eCollection 2023.
To explore the clinical outcomes of a 3D printing-assisted posterolateral approach for the treatment of ankle fractures involving the posterior malleolus.
A total of 51 patients with ankle fractures involving the posterior malleolus admitted to our hospital from January 2018 to December 2019 were selected. The patients were divided into 3D printing group (28 cases) and control group (23 cases). 3D printing was performed for ankle fractures, followed by printing of a solid model and simulation of the operation on the 3D model. The operation was then performed according to the preoperative plan, including open reduction and internal fixation via the posterolateral approach with the patient in the prone position. Routine x-ray and CT examinations of the ankle joint were performed, and ankle function was evaluated using the American Foot and Ankle Surgery Association (AOFAS) ankle-hindfoot score.
All patients underwent x-ray and CT examinations. All fractures healed clinically, without loss of reduction or failure of internal fixation. Good clinical effects were achieved in both groups of patients. The operation time, intraoperative blood loss and intraoperative fluoroscopy frequency in the 3D printing group were significantly less than those in the control group (< 0.05). There was no significant difference between the two groups in the anatomical reduction rate of fractures or the incidence of surgical complications (> 0.05).
The 3D printing-assisted posterolateral approach is effective in the treatment of ankle fractures involving the posterior malleolus. The approach can be well planned before the operation, is simple to perform, yields good fracture reduction and fixation, and has good prospects for clinical application.
探讨3D打印辅助后外侧入路治疗涉及后踝的踝关节骨折的临床疗效。
选取2018年1月至2019年12月我院收治的51例涉及后踝的踝关节骨折患者。将患者分为3D打印组(28例)和对照组(23例)。对踝关节骨折进行3D打印,随后打印实体模型并在3D模型上进行手术模拟。然后根据术前计划进行手术,包括患者俯卧位经后外侧入路切开复位内固定。对踝关节进行常规X线和CT检查,并采用美国足踝外科协会(AOFAS)踝-后足评分评估踝关节功能。
所有患者均接受了X线和CT检查。所有骨折均临床愈合,无复位丢失或内固定失败。两组患者均取得了良好的临床效果。3D打印组的手术时间、术中出血量和术中透视次数均显著少于对照组(<0.05)。两组骨折的解剖复位率或手术并发症发生率差异无统计学意义(>0.05)。
3D打印辅助后外侧入路治疗涉及后踝的踝关节骨折有效。该入路术前可进行良好规划,操作简单,骨折复位和固定效果好,具有良好的临床应用前景。