Clinical application of 3D printing technology in the surgical treatment of complex calcaneal fractures
10.3760/cma.j.issn.1008-6706.2019.19.003
- VernacularTitle: 3D打印技术在复杂跟骨骨折手术治疗中的临床应用研究
- Author:
Rongxi JI
1
Author Information
1. Department of Orthopedics, the People's Hospital of Zouping, Zouping, Shandong 256200, China
- Publication Type:Journal Article
- Keywords:
Imaging, three-dimensional;
Calcaneus;
Fractures, bone;
Surgical procedures, operative;
Preoperative period;
Postoperative period;
Patient satisfaction;
Blood loss, surgical
- From:
Chinese Journal of Primary Medicine and Pharmacy
2019;26(19):2314-2318
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of 3D printing technology in the surgical treatment of complex calcaneal fractures.
Methods:From December 2016 to November 2018, 42 patients with complex calcaneal fractures who met the inclusion criteria of this study in the People's Hospital of Zouping were selected in the study.All patients were selected for surgical treatment.The patients were divided into routine group (n=22) and 3D group (n=20) according to different pre-operative auxiliary conversation and operation methods.In order to intervene with routine clinical procedures in the routine group, three-dimensional digital model of calcaneus was established based on routine interventions in the 3D group, and three-dimensional data of calcaneal fracture model was measured.With the help of the model, the operation process of open window-bone reduction-bone grafting was demonstrated to patients and their families.
Results:In the 3D group, the preoperative conversation time was (12.03±2.15)min, the score of the patients' understanding of operation and illness was (9.12±0.56)points, the score of the patients' satisfaction with communication after operation was (9.61±0.54)points.In the routine group, the preoperative conversation time was (16.34±3.26)min, the score of the patients' understanding of operation and illness was (9.01±0.62)points, and the score of the patients' satisfaction with communication after operation was (9.61±0.54)points.The preoperative conversation time and the score of the patients' satisfaction with communication after operation of the 3D group were better than those of the routine group (t=4.216, 3.160, all P<0.05), but there was no statistically significant difference in the score of the patients' understanding of operation and illness between the two groups (P>0.05). The mean operative time of 22 patients in the 3D group was (102.56±18.47)min, the mean operative bleeding volume was (526.16±86.75)mL.The mean operative time of 20 patients in the routine group was (138.67±25.17)min, the mean operative bleeding volume was (741.24±120.15)mL.The operation indicators obtained in the 3D group were significantly better than those in the routine group (t=4.670, 6.124, all P<0.05). The Maryland scores of 22 patients in the 3D group were as follows: excellent in 11 cases (50.0%), good in 9 cases (40.9%), fair in 1 case (4.5%) and poor in 0 case (0.0%). The Maryland scores of 20 patients in the routine group were as follows: excellent in 10 cases (50.0%), good in 5 cases (25.0%), fair in 5 cases (25.0%) and poor in 0 case (0.0). Therefore, the Maryland scores of the 3D group were significantly better than those of the routine group (95.5% vs.75.0%), and the difference was statistically significant (χ2=4.260, P<0.05). In the 3D group, 22 patients were enrolled, the incidence rate of complications was 4.5% (1/22), and only one patient had delayed healing, In the routine group, the incidence rate of complications was 15.0% (3/20), including delayed healing in 1 case (5.0%), malunion in 1 case (5.0%) and incision infection in 1 case (5.0%), the difference was statistically significant (χ2=12.020, P<0.05).
Conclusion:The application of 3D printing technology in the surgical treatment of complex calcaneal fractures can significantly improve the preoperative conversation time and the satisfaction of communication after operation, shorten the operation time and reduce the amount of bleeding during operation.The clinical effect is ideal, safe and reliable, which is worthy of further promotion.
