Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Ophthalmology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Sci Rep. 2024 Oct 1;14(1):22771. doi: 10.1038/s41598-024-73715-y.
Enhance the efficiency of tibial transverse transport by employing customized 3D-printed osteotomy guide plates and striving to improve precision through CT evaluation for enhanced guide design. 17 diabetic foot patients were treated with the plate for tibial transverse transport. Preoperatively, we collected DICOM data from the affected tibia's CT and designed the geometric parameters of the tibial cortical bone window. A customized 3D-printed osteotomy guide plate was then fabricated using 3D printing technology. Postoperative X-ray and CT evaluations, conducted at two and five weeks post-surgery, assessed five crucial geometric parameters of the bone window. Measurements included the distance from the upper edge of the tibial cortical bone window to the tibial plateau, the distance from the anterior edge of the tibial cortical bone window to the bone ridge, the height of the tibial cortical bone window, the center-to-center distance between the 4.0 mm diameter Schanz pin and the osteotomy Kirschner pin, and the center-to-center distance of the 4.0 mm diameter Schanz pin. These measured parameters were subsequently compared to the preoperative design parameters. The Clinical trial registration number is ChiCTR2400087174. CT measurements showed no significant differences (P > 0.05) from preoperative design parameters across the five evaluated aspects. The average osteotomy duration was 35 ± 15 min with no bone window fractures. The bone window aligned effectively with the tibial shaft, achieving complete incorporation after distraction. A 4 to 8-month postoperative follow-up confirmed full healing of the tibial surgical wound and diabetic foot wounds. Utilizing customized 3D-printed osteotomy guide plates in tibial transverse bone transport surgery enables accurate translation of preoperative virtual designs into real-time procedures, enhancing surgical efficiency and quality.
采用定制的 3D 打印截骨导板,提高胫骨横向搬运效率,并通过 CT 评估来改进导板设计,以提高精度。17 例糖尿病足患者采用该截骨导板进行胫骨横向搬运。术前,我们从受影响胫骨的 CT 中收集 DICOM 数据,并设计胫骨皮质骨窗的几何参数。然后,使用 3D 打印技术制造定制的 3D 打印截骨导板。术后 2 周和 5 周进行 X 线和 CT 评估,评估骨窗的五个关键几何参数。测量包括胫骨皮质骨窗上边缘到胫骨平台的距离、胫骨皮质骨窗前缘到骨脊的距离、胫骨皮质骨窗的高度、4.0mm 直径 Schanz 钉和截骨克氏针的中心到中心距离,以及 4.0mm 直径 Schanz 钉的中心到中心距离。将这些测量参数与术前设计参数进行比较。临床试验注册号为 ChiCTR2400087174。CT 测量结果显示,五个评估方面的参数与术前设计参数无显著差异(P > 0.05)。平均截骨时间为 35 ± 15 分钟,无骨窗骨折。骨窗与胫骨骨干有效对齐,在牵开后完全融合。4 至 8 个月的术后随访证实胫骨手术伤口和糖尿病足伤口完全愈合。在胫骨横向骨搬运手术中使用定制的 3D 打印截骨导板,可以将术前虚拟设计准确转化为实时手术,提高手术效率和质量。