Study On The Application Of 3D Printing Technology In Distal Tibial Fractures

Objective: Using 3D printing technology to assist in the surgical treatment of Pilon fractures of the distal tibia,we discussed the differences,advantages and disadvantages with the traditional treatment techniques.Use computer-aided design and 3D printing technology to create internal ankle navigation templates.Experimental and feasibility analysis of guide plate assisted internal fixation of distal tibial oblique internal ankle fractures on lower extremity specimens.Methods: The first part of the clinical application study of 3D printing technology-assisted distal tibial Pilon fracture surgery: 30 patients with closed Rüedi-Allgower fractures of type III-V Pilon fractures diagnosed in our hospital from March 2020-December 2020 were collected,of which 15 patients were treated with traditional incision and reduction plate internal fixation surgery as the control group and 15 patients The 3D printing-assisted surgical treatment was used as the experimental group.The duration of surgery,frequency of fluoroscopic views,bleeding during and after surgery,wound infection,healing time of the fracture,and the Kofoed functional score of the ankle joint at 3 and 6 months after surgery were counted in the two groups,respectively.The second part of the experimental study of internal fixation of distal tibial oblique internal ankle fractures guided by 3D printed surgical guides: 12 specimens with intact bony structures of the lower limbs of adults were selected for modeling of distal tibial oblique internal ankle fractures in the anatomy department of the medical school.According to the principle of random grouping,6 sets were treated with navigation template-assisted screw placement for oblique internal ankle fractures as the experimental group,and 6 sets were treated with screws placed by traditional surgical method for oblique internal ankle fractures as the control group.The operation time and the number of intraoperative fluoroscopy were counted for the 2 groups,respectively.Results: The first part of the clinical application study of 3D printing technology-assisted distal tibial Pilon fracture surgery: the mean operating time was149.67±17.41 min in the control group and 129.33±15.79 min in the experimental group,which was significantly lower than that of the control group(P<0.05).The mean intraoperative bleeding was 110.67±15.80 ml in the control group and71.33±9.90 ml in the experimental group,which was significantly lower than that of the control group(P<0.05).The mean number of fluoroscopic views was 8.73±1.22 in the control group and 3.27±0.88 in the experimental group,and the number of fluoroscopic views in the experimental group was significantly lower than that in the control group(P<0.05).The mean postoperative drainage in the experimental group was 153.67±13.43 ml;the mean postoperative drainage in the control group was111.00±10.89 ml,and the postoperative drainage in the experimental group was significantly lower than that in the control group(P<0.05).The second part of the experimental study of internal fixation of distal tibial oblique internal ankle fractures guided by 3D printed surgical guide: the mean intraoperative fluoroscopy number was4.50±1.05 in the control group and 2.33±0.51 in the experimental group,and the fluoroscopy number was significantly lower in the experimental group than in the control group(P<0.05).The mean operative time was 35.00±5.90 min in the control group and 23.17±6.24 min in the experimental group,which was significantly lower than the control group between procedures(P<0.05).Conclusion: Compared with traditional surgical methods,the application of 3D printing technology in the treatment of Pilon fractures of the distal tibia can shorten the operating interval,reduce bleeding and postoperative drainage,reduce the number of intraoperative fluoroscopy,and improve postoperative ankle function,which has obvious clinical advantages.Compared with the traditional surgical method,the3D-printed navigation template guided screw fixation of distal tibial oblique internal ankle fracture is accurate in positioning,shortens the operation time and reduces the number of fluoroscopic views,and has further clinical application value.