【摘要】 [目的]评价3D打印个性化导板辅助螺钉内固Sanders Ⅱ和Ⅲ型跟骨骨折的临床效果。[方法]回顾性分析本院2014年6月—2019年12月采用空心拉力螺钉固定治疗SandersⅡ、Ⅲ型跟骨骨折78例患者的临床资料。依据术前医患沟通结果，39例采用3D打印个性化导板辅助螺钉内固定（3D组）；另外39例采用传统徒手空心螺钉内固定（传统组）。比较两组围手术期、随访和影像资料。[结果]3D组手术时间、切口长度、术中出血量、术后引流量、透视次数、切口愈合和住院时间均显著优于传统组（P<0.05）。随访时间12～43个月，平均（22.47±5.84）个月。3D组下地行走和完全负重时间显著早于传统组（P>0.05）。与术前相比，末次随访时两组患者的VAS评分显著减少（P<0.05），而AOFAS和Maryland评分均显著增加（P<0.05）。末次随访时3D组VAS、AOFAS和Maryland评分均显著优于传统组（P<0.05）。影像方面，与术前相比，末次随访时两组患者的跟骨B?hler角显著增加（P<0.05），而Gissane角显著减少（P<0.05）。末次随访时，3D组的B?hler角和Gissane角均显著优于传统组（P<0.05）。[结论]3D打印个性化导向器辅助螺钉内固定技术显著改善了Sanders Ⅱ和Ⅲ型跟骨骨折的临床效果。更多还原

【Abstract】 [Objective] To evaluate the clinical efficiency of personalized 3 D printed guider assisted screw placement for internal fixation of Sanders type Ⅱ and Ⅲ calcaneal fractures. [Methods] A retrospective study was conducted on 78 patients who received cannulated screw fixation of Sanders type Ⅱ and Ⅲ calcaneal fractures in our hospital from June 2014 to December 2019. According to the results of preoperative doctor-patient communication, 39 patients underwent personalized 3 D printed guider assisted internal fixation, while the other39 patients received internal fixation by conventional free-hand technique. The perioperative, follow-up and imaging documents were compared between the two groups. [Results] The 3 D group was significantly superior to the conventional group in terms of operation time, incision length, intraoperative blood loss, postoperative drainage, number of fluoroscopy, incision healing and hospital stay(P<0.05). The patients were followed up for 12～43 months, with an average of(22.47±5.84) months. The 3 D group resumed walking and full weight bearing activity significantly earlier than the conventional group(P>0.05). Compared with those preoperatively, the VAS scores decreased significantly(P<0.05), while the AOFAS and Maryland scores increased significantly in both groups at the latest follow-up(P<0.05). The 3 D group was significantly superior to the conventional group in terms of VAS, AOFAS and Maryland scores at the last interview(P<0.05). Regarding to radiographic assessment, the B?hler angle increased significantly(P<0.05), while the Gissane angle decreased significantly(P<0.05) in both groups at the latest follow up compared with those before operation. The 3 D group were significantly superior to the conventional group in the abovesaid imaging parameters at the latest follow-up(P<0.05). [Conclusion] The personalized 3 D printed guider assisted screw placement technique does significantly improve the clinical results of Sanders Ⅱ and Ⅲ calcaneal fractures.更多还原