实用医学杂志 ›› 2022, Vol. 38 ›› Issue (3): 375-379.doi: 10.3969/j.issn.1006⁃5725.2022.03.022

• 新技术新方法 • 上一篇    下一篇

3D打印联合距下关节镜治疗跟骨骨折

陈启刚 任戈亮 胡永军 刘佩雷 李强   

  1. 安徽理工大学第一附属医院(安徽淮南 232000)
  • 出版日期:2022-02-10 发布日期:2022-02-10
  • 通讯作者: 刘佩雷 E⁃mail:690791911@qq.com

3D printing combined with subtalar arthroscopy in treatment of calcaneal fractures

CHEN Qigang,REN Geliang,HU Yongjun,LIU Peilei,LI Qiang.    

  1. The First Affiliated Hospital of Anhui Technology University,Huainan 232000,China
  • Online:2022-02-10 Published:2022-02-10
  • Contact: LIU Peilei E⁃mail:690791911@qq.com

摘要:

目的 分析 3D 打印联合距下关节镜治疗跟骨骨折的临床价值。方法 选择 2019 年 1 月至2020 年 8 月入我院确诊跟骨骨折 Sanders Ⅱ⁃Ⅳ型患者 128 例为研究对象,随机分为对照组和观察组各64 例,对照组采用距下关节镜辅助下复位内固定术治疗跟骨骨折,观察组术前采用 3D 打印跟骨骨折模型并模拟手术方案。两组随访截至 2021 年 8 月,随访时间 12~31 个月,中位时间 25 个月。比较两组手术相关指标包括时间、出血量和并发症,术后住院时间和骨折愈合时间,关节功能包括 Böhler 角、Gissane 角和美国矫形足踝协会(AOFAS)评分。结果 两组手术时间和出血量比较差异无统计学意义(P > 0.05),但观察组并发症发生率低于对照组(P < 0.05)。观察组住院时间和骨折愈合时间比对照组短(P < 0.05)。两组治疗后 Bõhler 角和 Gissane 角比治疗前增加,且观察组明显大于对照组(P < 0.05)。观察组患者的足踝功能优良率高于对照组(P < 0.05)。结论 术前 3D 打印联合距下关节镜微创治疗 Sanders Ⅱ-Ⅳ型跟骨骨折有较好的临床安全性和有效性,能够显著降低围术期并发症,缩短骨折愈合和康复时间,改善足踝功能。

关键词:

3D 打印, 距下关节镜, 跟骨骨折

Abstract:

Objective To analyze the clinical value of 3D printing combined with subtalar arthroscopy intreatment of calcaneal fractures. Methods 128 patients with Sanders Ⅱ⁃Ⅳ calcaneal fractures diagnosis in thehospital from January 2019 to August 2020 were chose and randomly divided into the control group and the observa⁃tion group,where 64 patients were respectively included. The control group was treated with subtalar arthroscopicpercutaneous open reduction and internal fixation. The observation group was treated with 3D printed calcanealfracture model and simulated surgery scheme before operation. The two groups were followed up until August 2021,with follow⁃up time of 12~31 months and median time of 25 months. The operation related indexes including time,bleeding volume and complications,postoperative stay⁃in hospital days and fracture healing time,joint functionincluding Böhler angle,Gissane angle and American Orthopaedic Foot and ankle Association(AOFAS)score werecompared between the two groups. Results There were no differences of operative time and bleeding volumebetween the two groups(P > 0.05),while the incidence of complications in observation group was lower than thatin control group(P < 0.05). The stay⁃in hospital days and fracture healing time in the observation group were shorterthan those in the control group(P < 0.05). Böhler angle and gissane angle in the two groups increased after treat⁃ment. But those in observation group were significantly higher than control group(P < 0.05). The excellent andgood rate of foot and ankle function inobservation group was higher than control group(P < 0.05). Conclusion Preoperative 3D printing combined with subtalar arthroscopic minimally invasive treatment of Sanders Ⅱ-Ⅳ calca⁃neal fractures has good clinical safety and efficacy. It can greatly reduce perioperative complications and shortenfracture healing and rehabilitation time,while improving foot and ankle function.

Key words: 3D printing, subtalar arthroscopy, calcaneal fracture