3D打印技术辅助小切口微创经皮钢板内固定技术治疗SandersⅢ-Ⅳ型跟骨关节内骨折的疗效观察

The clinical observation of MIPPO technology in the treatment of Sanders Ⅲ-Ⅳ calcaneal intraarticular fracture with the assistance of 3D printing technology

目的探讨3D打印技术辅助下采用小切口微创经皮钢板内固定技术(NIPPO)治疗SandersⅢ-Ⅳ型跟骨关节内骨折的临床疗效。方法75例跟骨关节内骨折患者,按照是否采用3D打印技术辅助治疗分为观察组和对照组。对照组35例,仅行跗骨窦入路MIPPO治疗;观察组40例,采用3D打印技术辅助跟骨窦MIPPO治疗。比较两组的围手术期指标、手术效果及并发症发生情况。结果观察组的术中出血量、透视次数均少于对照组,手术时间及骨折愈合时间均短于对照组,手术治疗优良率(97.50%)高于对照组(80.0%),术后12个月的关节功能评分高于术前、对照组,患足Eohler角、Gissane角均大于术前、对照组,并发症发生率(2.50%)低于对照组(20.0%),差异均有统计学意义(P<0.05)。结论3D打印技术辅助跟骨窦MIPPO治疗SandersⅢ-Ⅳ型跟骨关节内骨折不仅能够准确评估骨折程度,还可提高手术效果。

Objective To analyze the clinical effect of MIPPO technology in the treatment of Sanders Ⅲ-Ⅳ calcaneal intra-articular fracture with the assistance of 3D printing technology.Methods 75 patients with intra-articular calcaneal fractures were divided into observation group and control group according to whether 3D printing technology was used for auxiliary txeatment.The 35 cases in the control group received only MIPPO treatment through the sinus tarsi approach;the 40 cases in the observation group received 3D printing technology to assist the MIPPO treatment of the calcaneal sinus.The perioperative indicators,surgical effects and complications of the two groups were compared.Results The intraoperative blood loss and the number of fluoroscopy in the observation group were less than those in the control group.The operation time and fracture healing time were shorter than those in the control group.The excellent and good rate of surgical treatment(97.50%)was higher than that of the control group(80.0%).The joint function score of the patient was higher than that of the preoperative and the control group.The B&hler angle and Gissane's angle of the affected foot were both greater than those of the preoperative and control group.The complication rate(2.50%)was lower than that of the control group(20.0%),and the differences were statistically significant(P<0.05).Conclusion 3D printing technology assisted MIPPO treatment of Sanders Ⅲ-Ⅳ calcaneal intra-articular fracture can not only accurately assess the degree of fracture,but also improve the surgical effect.