Podiatry Department, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, C/Ramiro de Maeztu 14, 46900 Torrent, Spain.
Institute for Research on Musculoskeletal Disorders, Faculty of Medicine and Health Sciences, Catholic University of Valencia San Vicente Mártir, C/Quevedo 2, 46001 Valencia, Spain.
Medicina (Kaunas). 2024 Oct 2;60(10):1613. doi: 10.3390/medicina60101613.
: Hallux valgus is a common foot deformity that requires surgical correction to restore proper alignment. Precision in the osteotomies performed during these surgeries is critical to avoid complications and improve outcomes. However, variability in surgeon experience can negatively affect precision. In this context, advances in 3D printing have enabled the development of customized surgical guides, which may enhance precision and reduce variability among surgeons with different levels of expertise. This study aims to evaluate the effectiveness of a 3D-printed surgical guide in minimally invasive hallux valgus correction, focusing on the accuracy of osteotomies performed by novice surgeons, experienced surgeons, and theoretically trained consultants. : An ex vivo study was performed with 30 cadaveric feet, divided into three groups according to the level of experience of the surgeons: 3D guide group, Master's students, professionals. All surgeons performed Akin and Reverdin-Isham osteotomies, but the experimental group (the 3D guide group) utilized a customized 3D-printed surgical guide for enhanced precision during these procedures. Radiographic measurements of osteotomy angles and alignment were taken after the interventions, and compared with the planned values. Statistical analyses were conducted to evaluate the variability in the precision of the cuts. : The use of the 3D-printed surgical guide significantly reduced angular variability in the experienced group, achieving higher levels of accuracy than experienced surgeons. Effect sizes, which ranged from small to large, indicated a greater impact on angle measurements (η = 0.46, < 0.001); no significant differences were found between the groups in other evaluated parameters. : The incorporation of 3D-printed surgical guides in hallux valgus surgery significantly improves osteotomy accuracy, particularly in less experienced surgeons. This suggests that these guides can help standardize procedures, reduce the learning curve, and lower intraoperative complications.
拇外翻是一种常见的足部畸形，需要手术矫正以恢复正常的排列。这些手术中进行的截骨术的精确性对于避免并发症和改善结果至关重要。然而，外科医生经验的差异可能会对精确性产生负面影响。在这种情况下，3D 打印技术的进步使得定制手术导板的开发成为可能，这可能会提高精度，并减少不同经验水平的外科医生之间的变异性。本研究旨在评估 3D 打印手术导板在微创拇外翻矫正中的有效性，重点关注新手外科医生、经验丰富的外科医生和理论培训顾问进行的截骨术的准确性。
进行了一项尸体足部的离体研究，根据外科医生的经验水平将 30 只尸体足部分为三组：3D 导板组、硕士研究生组和专业组。所有外科医生均进行 Akin 和 Reverdin-Isham 截骨术，但实验组（3D 导板组）在这些手术中使用定制的 3D 打印手术导板以提高精度。干预后，对截骨角度和对齐度进行影像学测量，并与计划值进行比较。进行统计分析以评估切口精度的变异性。
使用 3D 打印手术导板显著降低了经验丰富组的角度变异性，实现了比经验丰富的外科医生更高的准确性。效应大小范围从小到大，表明对角度测量的影响更大（η=0.46， < 0.001）；在其他评估参数方面，各组之间没有发现显著差异。
在拇外翻手术中加入 3D 打印手术导板可显著提高截骨术的准确性，特别是在经验较少的外科医生中。这表明这些导板可以帮助标准化手术过程，减少学习曲线，并降低术中并发症的风险。
