Clinical efficacy observation of 3D printing technology assisted treatment for high-energy complex Pilon fractures

HUANG Jianyun; WANG Benhai; LIU Zhongjie; ZHANG Jihao; ZHENG Mingsheng; ZHANG Luandi; ZHENG Jin-quan

doi:10.13919/j.issn.2095-6274.ZHJY202411003

Abstract：Objective To explore the clinical efficacy of 3D printing technology in assisting the treatment of high-energy complex Pilon fractures.Methods 96 patients with complex high-energy Pilon fractures who were hospitalized in the Orthopedics Department of the Third People's Hospital of Fujian Province from July 2018 to May 2023 were selected for treatment.According to different treatment methods,48 patients who received 3D printing technology assisted treatment were classified as the study group,while the other 48 patients who received conventional treatment were classified as the control group.The research group used 3D printing technology to print a solid model of the fracture site before surgery,simulated surgery using the solid model,reduced the fracture,pre bent the steel plate,marked the position of the steel plate,the direction and length of the nail placement;The con-trol group refers to imaging data such as CT and X-ray films;Both groups of patients underwent a single incision on the anterior lateral side of the lower leg to fully expose the fracture site.The control group attempted to reduce the bone block based on X-ray and CT images,and after reduction,selected a suitable steel plate for shaping and fixation.The study group reduced the fracture block according to the preoperative reduction sequence and method in the Pilon fracture 3D model simulation surgery,and fixed it with a pre selected steel plate.The intraoperative blood loss,operation time,and intraoperative fluoroscopy frequency in the control group were significantly higher than those in the study group.Results The study group had better joint surface reduction,lower inci-dence of adverse reactions,and faster fracture healing,with statistically significant differences(P＜0.05).The AOFAS score of the study group was higher than that of the control group patients one year after surgery,and the difference was statistically significant(P＜0.05).Con-clusion The application of 3D printing technology to assist in the treatment of complex high-energy Pilon frac-tures can significantly reduce bleeding,intraoperative fluoroscopy frequency,shorten surgical time,achieve good joint surface reduction,have a low incidence of adverse reactions,and have good ankle joint function recovery and fewer complications after surgery.