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一种用于跟骨全切除术后跟骨置换的3D打印模具的新型发明,用于复发性侵袭性跟骨骨巨细胞瘤。

A Novel Invention of a 3D Printed Mould for Calcaneum Replacement Post Total Calcanectomy for a Recurrent Aggressive GCT of the Calcaneum.

作者信息

Eyrique Goh Boay Heong, Keat Tee Kok, Paul Aaron Gerarde

机构信息

Orthopedic Oncology Unit, Orthopedic and Traumatology Hospital Queen Elizabeth I and II Sabah, Kuala Lumpur, Malaysia.

出版信息

Rev Bras Ortop (Sao Paulo). 2025 Jul 1;60(2):1-8. doi: 10.1055/s-0045-1809420. eCollection 2025 Apr.

Abstract

Advances in image processing have led to the clinical use of 3D printing technology, providing surgeons with realistic physical models of anatomy that enable them to recreate accurate bone structures. 3D-printed molds can play a central role in surgical replacements, offering both efficiency and cost-effectiveness. This case report describes the innovative creation of an anatomical calcaneum using a 3D printer. A patient presented with a recurrent aggressive stage of calcaneal giant cell tumor, which necessitated a complete resection, leaving a large void that required reconstruction. This paper outlines the 3D printing methodology used from pre-operative printing of the prototype, through the surgical procedure, to post-operative care. 3D images of the calcaneum were extracted from a CT scan and edited using 3D modelling software to print a hollow-shelled calcaneum. The printed prototype was created in two halves and sent for gas sterilization. After resecting the diseased calcaneum, the mold was filled with bone cement and clasped together with a proline mesh in between, for soft tissue attachment. Once the cement set, the shell was removed, and the shaped bone cement calcaneum was implanted into the patient with screws. The surrounding soft tissues and Achilles tendon were sutured to the mesh. Post-operatively, the patient was kept in a plaster dorsal slab for six weeks to allow for soft tissue incorporation. Six weeks after surgery, the patient began weight-bearing activities with an aesthetically shaped foot. This method for bone reconstruction is efficient, economical, and reproducible.

摘要

图像处理技术的进步推动了3D打印技术在临床上的应用,为外科医生提供了逼真的解剖实体模型,使他们能够重建精确的骨骼结构。3D打印模具在手术置换中可发挥核心作用,兼具效率和成本效益。本病例报告描述了使用3D打印机创新性制作解剖型跟骨的过程。一名患者出现复发性侵袭性跟骨巨细胞瘤,需要进行完整切除,留下一个需要重建的大空洞。本文概述了从术前打印原型到手术过程再到术后护理所使用的3D打印方法。从CT扫描中提取跟骨的3D图像,并使用3D建模软件进行编辑,以打印一个空心的跟骨。打印的原型分为两半制作,并送去进行气体灭菌。切除病变跟骨后,将模具填充骨水泥,并在中间用脯氨酸网扣合在一起,用于软组织附着。骨水泥凝固后,移除外壳,将塑形的骨水泥跟骨用螺钉植入患者体内。将周围的软组织和跟腱缝合到网片上。术后,患者用石膏背侧板固定六周,以使软组织融合。手术后六周,患者开始进行负重活动,足部外形美观。这种骨重建方法高效、经济且可重复。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0865/12213075/09e372a93b38/10-1055-s-0045-1809420-i2400226en-1.jpg

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