跟骨髓内钉结合3D打印导板治疗跟骨关节内骨折的效果观察  

Observation of calcaneal intramedullary nail combined with 3D printing guide plate in the treatment of calcaneal intra-articular fracture

作　　者：王磊[1] 张健[1] 陈青[1] 王来旭[1] 刘明超 WANG Lei;ZHANG Jian;CHEN Qing;WANG Laixu;LIU Mingchao(Department of Orthopedics,Binzhou Central Hospital,Binzhou,Shandong 251700,China)

机构地区：[1]山东省滨州市中心医院骨科,山东滨州251700

出　　处：《医药前沿》2022年第35期4-7,共4页Journal of Frontiers of Medicine

基　　金：山东省医药卫生科技发展计划项目(202104070562)。

摘　　要：目的:观察跟骨髓内钉结合3D打印导板治疗跟骨关节内骨折的效果。方法:分析2020年10月—2021年4月山东省滨州市中心医院收治的10例接受跟骨髓内钉系统结合3D打印导板治疗的跟骨关节内骨折患者的临床资料。所有患者均于术中外踝下小切口复位距下关节面,采用跟骨微创复位器械恢复跟骨长度、高度及宽度,将术前3D打印导板植入跟骨髓内钉,应用导向器置入载距突锁钉及距下关节面螺钉。评估该手术方法的初期治疗成果。结果:10例患者中5例获得3个月的随访,2例获得2个月的随访,其余3例获得术后2周随访。5例3个月随访中骨折全部一期愈合,其余患者骨折愈合顺利。所有患者均无手术切口感染、延迟愈合、深静脉血栓形成等早期并发症发生。术后采用踝-后足评分量表(A O F A S-A H S)评定后足功能:优7例,良2例,差1例,优良率为90.00%(9/10)。结论:跟骨髓内钉结合3D打印导板治疗跟骨关节内骨折的初期疗效良好,内固定可靠,有助于患者早期进行功能锻炼。Objective To observation effect of calcaneal intramedullary nail combined with 3D printing guide plate in the treatment of intra-articular calcaneal fractures.Methods The data of 10 calcaneal fracture patients treated by calcaneal intramedullary nailing system combined with 3D printing guide plate in the treatment of calcaneal intra-articular fracture from October 2020 to April 2021 were collected.All patients were treated with a small incision under the external malleolus during surgery to restore the length,height and width of the calcaneus,and the preoperative 3D printed guide was implanted into the internal nail of the marrow and the guide was inserted.The initial outcomes of this surgical approach was assessed.Results Five of the 10 patients received 3 months follow-up,2 received 2 months follow-up,and the remaining 3 received 2 weeks postoperative follow-up.All the fractures of the 5 patients healed in the first stage of the three-month follow-up,and the fractures of the remaining patients healed smoothly.None of the patients had early complications such as surgical incision infection,delayed healing,and deep vein thrombosis.The American Orthopedic Foot and Ankle Society Ankle-Hindfoot Scale(AOFAS-AHS)was used to evaluate the function of hind foot,7 cases were excellent,2 cases were good and 1 was poor,the excellent rate was(9/10).Conclusion The initial efficacy of calcaneal intramedullary nail combined with 3D printed guide plates in the treatment of calcaneal intra-articular fracture is good,and the internal fixation is reliable,which is helpful for patients to perform functional exercise in the early stage.

关 键 词：跟骨骨折 髓内钉固定 骨折固定术 计算机辅助设计 

分 类 号：R683[医药卫生—骨科学]