3D打印技术辅助微创复位螺钉内固定治疗老年SandersⅡ~Ⅲ型跟骨骨折患者的疗效  

Efficacy of 3D printing-assisted minimally invasive reduction and screw internal fixation in elderly patients with Sanders typeⅡ-Ⅲcalcaneal fractures

作　　者：姜楠 齐波 姚玲 杨晟 JIANG Nan;QI Bo;YAO Ling;YANG Sheng(Department of Orthopedics,the 920th Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China,Kunming 650032,China)

机构地区：[1]中国人民解放军联勤保障部队第九二〇医院骨科,云南昆明650032

出　　处：《机器人外科学杂志(中英文)》2025年第3期362-367,共6页Chinese Journal of Robotic Surgery

基　　金：云南省临床医学研究中心项目(202102AA30068)。

摘　　要：目的:探讨3D打印技术辅助微创复位螺钉内固定治疗老年SandersⅡ~Ⅲ型跟骨骨折患者的疗效及其安全性。方法:回顾性分析2021年5月—2024年5月中国人民解放军联勤保障部队第九二〇医院收治的100例老年跟骨骨折患者,根据不同手术方式分为3D打印组(n=43,行3D打印技术辅助微创复位螺钉内固定治疗)与常规组(n=57,行微创复位螺钉内固定治疗)。比较两组患者的围手术期指标、主观疼痛感受、术后功能评分、生活质量、末次随访跟骨形态及并发症发生情况。结果:3D打印组的手术时间、切口长度、透视次数、术中失血量、住院时间以及治疗费用均少于常规组(P<0.05)。3D打印组术后1~4 d疼痛视觉模拟评分法(VAS)评分均低于常规组(P<0.05)。两组患者美国足踝外科协会(AOFAS)踝-后足评分、Maryland足功能评分、健康状况调查简表(SF-36)评分均随时间推移而明显升高,且3D打印组术后1个月、3个月及6个月的AOFAS踝-后足评分、Maryland足功能评分、SF-36评分高于常规组(P<0.05)。3D打印组的Bohler角、Gissanc角、跟骨高度大于常规组,跟骨宽度小于常规组(P<0.05)。两组患者并发症总发生率比较,差异无统计学意义(P>0.05)。结论:3D打印技术应用于老年SandersⅡ~Ⅲ型跟骨骨折微创复位螺钉内固定治疗患者的短期效果显著,可有效缓解患者疼痛,显著提高术后功能水平,改善生活质量。Objective:To investigate the efficacy and safety of 3D printing-assisted minimally invasive reduction and screw internal fixation in elderly patients with Sanders typeⅡ-Ⅲcalcaneal fractures.Methods:A retrospective analysis was conducted on 100 elderly patients with calcaneal fractures who were treated at the 920th Hospital of the Joint Logistics Support Force of the People’s Liberation Army of China from May 2021 to May 2024.Patients were divided into the 3D printing group(n=43,treated with 3D printing-assisted minimally invasive reduction and screw internal fixation)and the conventional group(n=57,treated with standard minimally invasive reduction and screw internal fixation).Perioperative indicators,subjective pain perception,postoperative functional scores,quality of life,calcaneal morphology at final follow-up,and complications were compared between the two groups.Results:The 3D printing group demonstrated significantly shorter operative time,smaller incision length,fewer intraoperative fluoroscopies,reduced blood loss,shorter length of hospital stay,and lower treatment costs compared to the conventional group(P<0.05).The Visual Analogue Scale(VAS)scores on 1-4 days after surgery were significantly lower in the 3D printing group(P<0.05)than those in the conventional group.Both groups showed progressive improvements in the American Orthopaedic Foot and Ankle Society(AOFAS)Ankle-Hindfoot Score,Maryland foot function score,and Short Form-36(SF-36)quality of life score over time.However,the 3D printing group showed higher scores at 1,3,and 6 months after surgery(P<0.05),and greater restoration of Böhler’s angle,Gissane’s angle,and calcaneal height,along with narrower calcaneal width compared to the conventional group(P<0.05).No significant difference was observed in overall complication rates between the two groups(P>0.05).Conclusion:The application of 3D printing technology in minimally invasive reduction and screw internal fixation for elderly patients with Sanders typeⅡ-Ⅲcalcaneal fractures had

关 键 词：跟骨骨折 老年患者 微创手术 内固定 3D打印技术 

分 类 号：R687.3[医药卫生—骨科学]