Application Of 3D Printing Technology In The Surgical Management For Calcaneal Fracture And Analysis Of Its Outcome

Objective:To explore the role of guidance of 3D printing technology in the surgical management for calcaneal fracture and to compare the clinical outcome differences between the two different treatment options.Methods:From March 2015 to August 2017,patients diagnosed with calcaneal fracture in our hospital were retrospectively reviewed.Thirty patients undergoing unilateral operation were randomly divided into two groups,the study group and the control group.The control group(routine group)underwent CT scans of the affected foot before operation,the ORIF were performed routinely。CT scans of both affected and normal foot were obtained for the study group(3D printing group)before operation,the model of affected calcaneus(before injury)was simulated and printed using mirror image principle of the normal calcaneus.By comparing,labeling and reduction simulation,the plate and screws were prefabricated,the ORIF were performed under the guidance of 3D print Model。The operation time,times for intraoperative fluoroscopy,intraoperative bleeding volume,postoperative bleeding volume,successful rate for sustentaculum screw introduction,wound healing,bone healing time and MSF foot function score were recorded for both groups.Finally,statistical analysis was performed to compare the difference between these two groups.Results:1.By observing the 3D printing model,15 cases can be classified more accurately.The calcaneal model reconstructed by mirror image principle is practicable,and the intraoperative findings were in accordance with the preoperative simulation.2.The mean operative time for control group was 80.533±15.16 minutes,while it was 58.93± 11.25 minutes for study group(P<0.001).The average intraoperative and postoperative bleeding volume for control group was 108.67±28.75 ml and 226.80±66.39ml,while it was 98.67± 16.85ml and 168.67±41.19ml for study group(p>0.05,p<0.05),The times of intraoperative fluoroscopy for control group was 7.80± 1.82 times,while it was 3.93±0.88 times for study group(P<0.001);successful rate for sustentaculum screw introduction for control group was 9/6,while it was 14/1 for study group(P<0.05).The average bone healing time for control group was 3.30±0.59 months,while it was 3.00±0.38 months for study group(P>0.05).The average MSF foot function score for control group was 88.07±4.91 points,while it was 91.33±2.79 points for study group(P<0.05).Conclusion:In this study,the operation time,times of intraoperative fluoroscopy,postoperative bleeding volume,the successful rate for sustentaculum screw introduction in the study group was significantly better than that in the control group.The MSF foot function score was also significantly improved.3D printing technique provides good guidance for the treatment of calcaneal fracture,preoperative communication between doctors and patients,formulation of operative plan,reduction of fracture block and selection of internal fixation.it is beneficial to the precise reduction of bone mass and the reduction of operative trauma In operation,and also beneficial to the recovery of foot function after operation.