3D打印技术联合跗骨窦微创切口在跟骨骨折手术中的应用

Clinical application of 3D printing combined with minimally invasive sinus sinus in calcaneal fracture surgery

目的研究3D打印技术联合跗骨窦微创切口在跟骨骨折手术中的临床应用。方法选择72例跟骨骨折手术患者为研究对象,根据手术方法分为两组:传统L型切口手术组(常规组,34例)和3D打印技术联合跗骨窦微创切口手术组(3D打印微创组,38例)。记录等待手术时间、手术时间、失血量和切口愈合情况;通过AOFAS后足评分评估患肢功能;通过放射学评估术前及术后的Bohler角和Gissane角;统计术后切口疼痛发生率和术后切口并发症发生率。结果 3D打印微创组等待手术时间、手术时间和失血量显著短于常规组;术后X线片显示两组跟骨Bohler角和Gissane角均显著改善,但3D打印微创组恢复效果较好。根据AOFAS评分,优秀和良好率在3D打印微创组中高于常规组;3D打印微创组术后切口疼痛发生率和术后切口并发症显著低于常规组。结论与传统L型入路治疗移位的跟骨关节内骨折比较,经3D打印技术联合跗骨窦微创切口更安全有效,术后并发症发生率较低。

Objective To study the clinical application of 3D printing combined with minimally invasive sinus sinus in the treatment of calcaneal fractures. Methods Seventy-two patients with root fractures were selected as the study subjects. According to different surgical methods, the patients were divided into two groups: L-shaped incision lateral approach traditional surgery group(regular group, n=34 cases) and 3D printing technique combined with Sinus minimally invasive incision surgery group(3D print group, n=38 cases). The operation time, blood loss and wound healing were recorded. The function of the affected limb was evaluated by AOFAS hindfoot score. Bohler angle and Gissane angle before and after surgery were evaluated by radiology. The incidence of postoperative incision pain and postoperative wounds were counted. Results The operation time and blood loss of the 3D printing group were significantly shorter than those of the conventional group. The postoperative X-ray showed significant improvement in both the humeral Bohler angle and the Gissane angle, but the 3D printing group had better recovery. According to the AOFAS score, the excellent and good rate was significantly higher in the 3D printing group than that in the conventional group;the incidence of postoperative incision pain and postoperative wound complications in the 3D printing group was significantly lower than that in the conventional group. Conclusions Compared with the L-shaped lateral approach for displaced intra-articular fractures, the 3D printing technique combined with the minimally invasive sinus sinus incision is safer and more effective, and the postoperative complication rate is lower.