Application of three-dimensional printing technology combined with bone cement in minimally invasive treatment of the collapsed Sanders III type of calcaneal fractures

doi:10.12307/2021.080

Abstract

Abstract: BACKGROUND: The treatment of calcaneal fracture is still controversial at present. Traditional complications of open reduction remain high, while minimally invasive treatment has few indications and its application is limited. In recent years, with the development of three-dimensional (3D) printing technology, whether the indications of minimally invasive treatment can be expanded and achieve good results or not is the focus and hot spot of study on the treatment of calcaneal fracture.
OBJECTIVE: To explore the application value of 3D printing technology in the minimally invasive treatment of collapsed Sanders III calcaneal fractures.
METHODS: Eight patients with nine foot Sanders III calcaneal fractures who were admitted to the Department of Hand and Foot Surgery of Zhangjiagang Hospital Affiliated to Soochow University from September 2016 to April 2017. All were males, aged 50-66 years, with an average age of 57.4 years. All patients underwent CT examination and obtained 3D printed personalized posterior foot, followed by bone cement filling surgery assisted by pry reduction after simulating the position and angle of pry needle. The length, width and height of calcaneu and the Gissane angle and Bohler angle before and after surgery of all patients were recorded. The postoperative function was evaluated according to the American Orthopedic Foot Ankle Society Ankle Hindfoot Scale.
RESULTS AND CONCLUSION: (1) All patients were followed up for 26-36 months. All fractures healed. There was no collapse, leakage of bone cement, rejection reaction, skin necrosis or infection. Calcaneal shape recovered satisfactorily, and foot function was good. (2) American Orthopedic Foot Ankle Society Ankle Hindfoot Scale results showed excellent in seven cases, good in one case, and poor in one case, with excellent and good rate of 89%. (3) Bohler angle and Gissane angle of patients respectively improved from (15.73±2.46)° and (145.34±8.6)° before surgery to (25.77±2.65)° and (127.5±8.17)° after surgery. Difference was statistically significant (P < 0.001). There was no significant difference in Bohler angle and Gissane angle between immediately, and 1, 2 years after operation (P > 0.05). (4) It is indicated that 3D printing individualized bone cement filling plays an important clinical role in the treatment of collapsed Sanders III calcaneal fracture and it has the advantages of short time of individualized targeted operation, minor surgical injury, and few complications.

Key words: calcaneal fracture, 3D printing, bone cement, pry reduction, minimally invasive

CLC Number:

Meng Lingjie, Qian Hui, Sheng Xiaolei, Lu Jianfeng, Huang Jianping, Qi Liangang, Liu Zongbao. Application of three-dimensional printing technology combined with bone cement in minimally invasive treatment of the collapsed Sanders III type of calcaneal fractures[J]. Chinese Journal of Tissue Engineering Research, 2021, 25(24): 3784-3789.

Figures/Tables 4

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