摘要
目的探讨3D打印导航模板辅助钢板内固定术治疗SandersⅢ、Ⅳ型跟骨骨折的效果。方法回顾性分析2015年1月-2018年8月深圳市盐田区人民医院收治的SandersⅢ、Ⅳ型跟骨骨折患者105例,男性67例,女性38例;年龄23~59岁,平均36.5岁;SandersⅢ型58例,Ⅳ型47例。根据手术方式不同分为3D组(55例)和常规组(50例),3D组行3D打印导航模板辅助钢板内固定术,常规组行常规复位内固定。观察两组患者围术期情况及疗效,术前及术后6个月AOFAS评分和Maryland评分、Bohler角和Gissane角。结果 3D组手术时间及术中出血量少于常规组[(52.24±6.37) min vs.(61.96±8.86) min、(22.84±2.76) mL vs.(28.51±5.68) mL],差异有统计学意义(P<0.05);3D组住院时间及X线片透视次数少于常规组[(11.42±4.35)d vs.(12.83±5.95)d、(4.23±1.34)次vs.(4.54±1.44)次],但差异无统计学意义(P>0.05);3D组优良率90.91%高于常规组76.00%,差异有统计学意义(P<0.05);两组患者术后6个月的AOFAS评分、Maryland评分及Bohler角均较术前显著提高,Gissane角均较术前显著降低(P <0.05);3D组并发症发生率10.91%低于常规组18.00%,但两者比较差异无统计学意义(P>0.05)。结论 3D打印导航模板辅助钢板内固定术治疗SandersⅢ、Ⅳ型跟骨骨折可缩短手术时间,降低术中出血量,安全可靠。
Objective To investigate the effect of 3 D printing navigation template assisted plate internal fixation in the treatment of Sanders type Ⅲ and Ⅳ calcaneal fractures.Methods Totally 105 patients with Sanders type Ⅲ and Ⅳ calcaneal fractures who were treated in our hospital from Jan.2015 to Aug.2018 were analyzed retrospectively.There were 67 males and 38 females with an average of 36.5(23-59) years.According to the operation,they were divided into 3 D group(55 cases) and routine group(50 cases).Patients in the routine group were treated with conventional reduction and internal fixation,while patients in the 3 D group were treated with 3 D printing navigation template assisted with plate internal fixation.The preoperative and postoperative AOFAS scores,Maryland scores,Bohler angle and gissane angle were compared between the two groups.Results The operation time and intraoperative blood loss in 3 D group were shorter than those in routine group,and there were significant differences[(52.24±6.37) min vs.(61.96±8.86) min,(22.84±2.76) mL vs.(28.51±5.68) mL,P <0.05];the hospitalization time and X-ray fluoroscopy times in 3 D group were less than those in routine group [(11.42±4.35) d vs.(12.83±5.95) d,(4.23±1.34) times vs.(4.54±1.44) times],and there was no significant difference(P>0.05);the excellent and good rate of 3 D group was 90.91%,higher than 76.00% of routine group,and the difference was statistically significant(P <0.05);the AOFAS score,Maryland score and Bohler angle of the two groups after operation were significantly higher than those before operation,and the Gissane angle was significantly decreased(P <0.05).The incidence of complications in 3 D group was 10.91%,lower than that in routine group(18.00%),but there was no significant difference between them(P> 0.05).Conclusion 3 D printing navigation template assisted plate internal fixation for sanders type Ⅲ and Ⅳ calcaneal fractures can shorten the operation time and reduce the amount of intraoperative bleeding,which is safe and reliable.
作者
李冬寒
钟昌戎
林泽宏
董国林
周枭
陈志强
梁比记
LI Dong-han;ZHONG Chang-rong;LIN Ze-hong;DONG Guo-lin;ZHOU Xiao;CHEN Zhi-qiang;LIANG Bi-ji(Department of Orthopedics,Shenzhen Yantian District People's Hospital Group,Shenzhen Guangdong 518000,China)
出处
《创伤外科杂志》
2020年第4期250-254,共5页
Journal of Traumatic Surgery
关键词
跟骨骨折
3D打印
导航模板
钢板
内固定
calcaneal fracture
3D printing
navigation template
plate
internal fixation
