Clinical application of 3D printing technique in surgical treatment of Sanders Ⅱ&Ⅲ type calcaneal fracture

CHEN Ke; PAN Zhen-yu

doi:10.3969/j.issn.1009-4237.2017.07.008

Abstract：Objective To investigate the clinical application and curative effect of 3D printing technology (three-dimensional printing,TDP) in surgical treatment of calcaneal fracture.Methods Data of 80 patients with Sanders typeⅡ,Ⅲ calcaneal fractures were retrospectively analyzed,who were admitted in Zhongnan Hospital of Wuhan University from Feb.2013 to Jan.2016. There were 53 males and 27 females;age ranged from 25 to 62 years (mean 37. 3 years).There were 37 cases of left foot injury and 43 cases of right foot injury;52 cases of Sanders typeⅡand 28 cases of Sanders type Ⅲ.The subjects were divided into 3D print assisted therapy group(TDP group,40 cases,40 feet)and routine open reduction and internal fixation group(control group,40 cases,40 feet).In TDP group,1:1 3D fracture model was printed before operation.The operation group planned the operation according to the 3D model before operation,formulated and implemented individualized treatment plan and doctor-patient communication.The control group received routine open reduction and internal fixation and preoperative doctor-patient communication.The operation times,fluoroscopy times,the time of use of the tourniquet,the incidence of incisional complications,the efficiency of the doctor-patient communication,and the Maryland foot score were compared between the two groups.Results The operation time,the tourniquet compression time and fluoroscopy times were(105.0±14.2)min,(78.0±14.4)min and(3.4±2.9)times,respectively,which were shorter than those of the control group ((153.0±37.6) min,(115.0±28.6)min,(8.5±1.2)times,respectively),and the differences were statistically significant(P<0.05).The incidence of incision complications in the TDP group (5.0%) was lower than that in the control group (20.0%),and the difference was statistically significant(P<0.05).Questionnaire was used to evaluate the communication effect between doctors and patients,which was better in the TDP group than that in the control group,and the difference was statistically significant(P<0.05).The postoperative Maryland foot score indicated excellent in 13 cases,good in 22 cases,and fair in 5 cases in the TDP group,with the excellent and good rate of 87.5%.while in the control group ,there were 11 cases of excellent,23 cases of good,5 cases of fair,and 1 case of poor,with the excellent and good rate of 85.0%.There was no statistical difference in the comparison of foot function between the two groups(P>0.05).Conclusion 3D printing technology assistants the surgical treatment of SandersⅡ,Ⅲ type calcaneal fracture,can shorten the operation time,reduce the complication rate of incision and improve the communication effect between doctors and patients.