3D printing-assisted percutaneous balloon dilatation plasty for treatment of osteoporotic calcaneal fractures of Sanders type Ⅱ or Ⅲ in the elderly patients北大核心CSCD |
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引用本文: | 沈磊,王强,蒋臻欢,陈俊,张洪涛,史金辉,吴晨光,陈亮.3D printing-assisted percutaneous balloon dilatation plasty for treatment of osteoporotic calcaneal fractures of Sanders type Ⅱ or Ⅲ in the elderly patients北大核心CSCD[J].中华创伤骨科杂志,2022(10):839-847. |
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作者姓名: | 沈磊 王强 蒋臻欢 陈俊 张洪涛 史金辉 吴晨光 陈亮 |
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作者单位: | 1.江苏省宜兴市人民医院骨科214200;2.苏州大学附属第一医院骨科215006; |
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基金项目: | 江苏省卫生健康委医学科研项目(Z2020006);江苏省卫生国际交流项目(JSH-2018-17);无锡市卫健委医学重点人才项目(ZRDC018)。 |
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摘 要: | Objective To compare the clinical efficacy between 3D printing-assisted percutaneous balloon dilatation calcaneal plasty (3D-PCP) and conventional open reduction and internal fixation (ORIF) via the extended lateral L-shaped approach in the treatment of osteoporotic calcaneal fractures of Sanders type Ⅱ or Ⅲ in the elderly patients. Methods Retrospectively analyzed were the data of 36 elderly patients with osteoporotic calcaneal fracture of Sanders type Ⅱ or Ⅲ who had been surgically treated at Department of Orthopaedics, Yixing People's Hospital from June 2012 to June 2018. According to their treatment methods, the patients were divided into a 3D-PCP group 16 cases, 9 males and 7 females with an age of (73.0 ± 3.4) years] and an ORIF group 20 cases, 8 females and 12 females with an age of (71.4 ± 2.6) years]. The 2 groups were compared in terms of hospital stay, operation time, intraoperative fluoroscopy frequency, suture removal time, weight bearing time, fracture healing time, visual analogue scale (VAS) for the surgical site 2 days and one year after surgery, American Foot and Ankle Surgery Association (AOFAS) ankle-hindfoot score, calcaneal imaging parameters (Böhler angle, Gissane angle, and length, width and height of the calcaneus axis) at 2 days and one year after surgery, and postoperative complications. Results There was no significant difference in the preoperative general data between the 2 groups, showing comparability (P > 0.05). All patients were followed up for 14 to 18 months (mean, 15.6 months). Compared with the ORIF group, the 3D-PCP group had significantly shorter hospital stay, significantly shorter operation time, significantly earlier suture removal, significantly earlier weight-bearing, significantly lower VAS scores at 2 days after surgery, significantly higher AOFAS ankle-hindfoot scores at one month after surgery, but significantly more times of intraoperative fluoroscopy (all P < 0.05). In all patients, the VAS scores at 2 days after surgery were significantly lower than those before surgery, and those at one year after surgery significantly lower than those at 2 days after surgery (P < 0.05). In all patients, the AOFAS ankle-hindfoot scores at one month after surgery were significantly higher than those before surgery (P < 0.001). In the ORIF group, the AOFAS ankle-hindfoot scores at one year after surgery were significantly higher than those at one month after surgery (P < 0.05), but in the 3D-PCP group there was no such a significant difference between one year and one month after surgery (P > 0.05). There was no significant difference in VAS score, AOFAS score, fracture healing time or postoperative imaging parameters between the 2 groups at one year after surgery (P > 0.05). There was no significant difference either in the incidence of complications between the 2 groups (P > 0.05). Conclusion In the treatment of osteoporotic calcaneal fractures of Sanders type Ⅱ or Ⅲ in the elderly patients, compared with conventional ORIF, 3D-PCP shows advantages of shorter operation time, minimal invasion, quicker incision healing, shorter hospital stay, earlier weight-bearing exercise, and better functional recovery but a disadvantage of increased times of intraoperative fluoroscopy. © 2022 Chinese Journal of Orthopaedic Trauma. All rights reserved.
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关 键 词: | 跟骨 骨折 骨折固定术 内 骨质疏松 经皮球囊扩张成形术 3D打印 |
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