Chinese Journal of Tissue Engineering Research ›› 2021, Vol. 25 ›› Issue (18): 2822-2826.doi: 10.3969/j.issn.2095-4344.3844

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Three-dimensional printing combined with subtalar arthroscope assisted reduction and internal fixation with percutaneous screw with mechanical arm for calcaneal fractures

Liu Yanzi, Gao Wuchang   

  1. Department of Foot and Ankle Surgery, Zibo Seventh People’s Hospital, Zibo 255000, Shandong Province, China 
  • Received:2020-07-20 Revised:2020-07-22 Accepted:2020-08-25 Online:2021-06-28 Published:2021-01-11
  • Contact: Gao Wuchang, Chief physician, Department of Foot and Ankle Surgery, Zibo Seventh People’s Hospital, Zibo 255000, Shandong Province, China
  • About author:Liu Yanzi, Master, Physician, Department of Foot and Ankle Surgery, Zibo Seventh People’s Hospital, Zibo 255000, Shandong Province, China

Abstract: BACKGROUND: The treatment of calcaneal fracture has a long history. Traditional L-shaped approach is the most widely used surgical approach, fully exposed, but with a high postoperative complication rate. How to achieve accurate internal fixation of calcaneal fracture while reducing postoperative complications is the current direction of medical research. Three dimensional (3D) printing, arthroscopy, and robotic-assisted surgery offer new ideas for treatment.
OBJECTIVE: To explore the clinical effect of 3D printing combined with subtalar arthroscope assisted reduction and internal fixation with percutaneous screw assisted by mechanical arm for calcaneal fractures. 
METHODS: Totally 62 patients with Sanders II and Sanders III calcaneal fractures were enrolled and divided into two groups. The observation group (n=30) received 3D printing combined with subtalar arthroscope assisted reduction and internal fixation with percutaneous screw assisted by mechanical arm. The traditional group (n=32) received traditional L-shaped approach. Preoperative waiting time, surgical time, accuracy of screw placement, fluoroscopy times, blood loss, incidence of postoperative complications, fracture healing time, calcaneal width, Bohler angle, Gissane angle, visual analogue scale scores, and Maryland scores were recorded and compared between the two groups.
RESULTS AND CONCLUSION: (1) The preoperative waiting time, surgical time, fluoroscopy times, blood loss, incidence of postoperative complications, and fracture healing time of the observation group were all less than those of the traditional group (P < 0.05). (2) The precision rate of screw placement in the observation group was much higher than that in the traditional group (P < 0.05). (3) Visual analogue scale scores and Maryland scores had no significant difference between the two groups (P > 0.05). (4) It is indicated that 3D printing combined with subtalar arthroscope assisted reduction and internal fixiation with percutaneous screw assisted by mechanical arm for calcaneal fractures is minimally invasive, with short preoperative waiting time, short operation time, accurate screw placement, low postoperative complications and less healing time; it is a reliable treatment for calcaneal fractures.

Key words: calcaneal fracture, percutaneous screw, internal fixation, 3D printing, subtalar arthroscopy, mechanical arm

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