3D打印辅助螺钉内固定Sanders Ⅱ和Ⅲ型跟骨骨折  

3D printing assisted cannulated screw placement for internal fixation of Sanders type Ⅱ and Ⅲ calcaneal fractures

作　　者：路磊[1] 李朋 宋财[1] LU Lei;LI Peng;SONG Cai(Department of Traumatology and Orthopedics,Bozhou People's Hospital,Bozhou 236800,China)

机构地区：[1]亳州市人民医院创伤骨科,安徽亳州236800

出　　处：《中国矫形外科杂志》2021年第19期1759-1763,共5页Orthopedic Journal of China

摘　　要：[目的]评价3D打印个性化导板辅助螺钉内固Sanders Ⅱ和Ⅲ型跟骨骨折的临床效果。[方法]回顾性分析本院2014年6月-2019年12月采用空心拉力螺钉固定治疗Sanders Ⅱ、Ⅲ型跟骨骨折78例患者的临床资料。依据术前医患沟通结果,39例采用3D打印个性化导板辅助螺钉内固定(3D组);另外39例采用传统徒手空心螺钉内固定(传统组)。比较两组围手术期、随访和影像资料。[结果]3D组手术时间、切口长度、术中出血量、术后引流量、透视次数、切口愈合和住院时间均显著优于传统组(P<0.05)。随访时间12~43个月,平均(22.47±5.84)个月。3D组下地行走和完全负重时间显著早于传统组(P>0.05)。与术前相比,末次随访时两组患者的VAS评分显著减少(P<0.05),而A0FAS和Maryland评分均显著增加(P<0.05)。末次随访时3D组VAS、A0FAS和Maryland评分均显著优于传统组(P<0.05)。影像方面,与术前相比,末次随访时两组患者的跟骨Biihler角显著增加(P<0.05),而Gissane角显著减少(P<0.05)。末次随访时,3D组的B6hler角和Gissane角均显著优于传统组(P<0.05)。[结论]3D打印个性化导向器辅助螺钉内固定技术显著改善了Sanders II和III型跟骨骨折的临床效果。[Objective]To evaluate the clinical efficiency of personalized 3D printed guider assisted screw placement for internal fixation of Sanders type Ⅱ and Ⅲ calcaneal fractures.[Methods]A retrospective study was conducted on 78 patients who received cannulated screw fixation of Sanders type Ⅱ and Ⅲ calcaneal fractures in our hospital from June 2014 to December 2019.According to the results of preoperative doctor-patient communication,39 patients underwent personalized 3D printed guider assisted internal fixation,while the other 39 patients received internal fixation by conventional free-hand technique.The perioperative,follow-up and imaging documents were compared between the two groups.[Results]The 3D group was significantly superior to the conventional group in terms of operation time,incision length,intraoperative blood loss,postoperative drainage,number of fluoroscopy,incision healing and hospital stay(P<0.05).The pa-tients were followed up for 12〜43 months,with an average of(22.47±5.84)months.The 3D group resumed walking and full weight bearing activity significantly earlier than the conventional group(P>0.05).Compared with those preoperatively,the VAS scores decreased significantly(P<0.05),while the AOFAS and Maryland scores increased significantly in both groups at the latest follow-up(P<0.05).The 3D group was significantly superior to the conventional group in terms of VAS,AOFAS and Maryland scores at the last interview(P<0.05).Regarding to radiographic assessment,the Bohler angle increased significantly(P<0.05),while the Gissane angle decreased significantly(P<0.05)in both groups at the latest follow up compared with those before operation.The 3D group were significantly superior to the conventional group in the abovesaid imaging parameters at the latest follow-up(P<0.05).[Conclusion]The personalized 3D printed guider assisted screw placement technique does significantly improve the clinical results of Sanders Ⅱ and Ⅲ calcaneal fractures.

关 键 词：跟骨骨折 3D打印 内固定 临床效果 

分 类 号：R683.42[医药卫生—骨科学]