3D打印导板辅助跟骨截骨术治疗Haglund综合征的临床研究

Clinical Study on 3D-Printed Guide-Assisted Calcaneal Osteotomy for the Treatment of Haglund Syndrome

摘要:

摘要：［目的］探讨3D打印导板辅助跟骨截骨术治疗Haglund综合征的临床疗效。［方法］回顾性分析本院2021年1月至2022年6月收治的37例Haglund综合征的患者资料，根据医患沟通结果，17例采用3D打印导板辅助跟骨截骨术（导板组），20例采用徒手方式下行跟骨截骨术（徒手组）。比较两组临床及影像结果。［结果]导板组手术时间[（42.8±4.1min vs （50.2±4.2）min，P＜0.05]和术后透视次数[（0.6±0.6）次 vs （50.2±4.2次），P＜0.05]均显著优于徒手组，两组在住院时间、切口长度、术中出血量、伤口愈合上无统计学意义（P＞0.05）。随着术后时间推移，与术前相比，两组VAS评分显著减少（P＞0.05），AOFAS评分显著提高（P＜0.05）。末次随访时两组之间的VAS评分无统计学意义（P＞0.05）；末次随访时两组之间的导板组的AOFAS评分[（96.5±2.9）vs（94.4±3.3），P＜0.05]优于徒手组。影像学方面，术前两组间FPA和X/Y比值差异无统计学意义（P＞0.05）。与术前相比，两组末次随访时，FPA显著减小（P＜0.05），X/Y比值显著增大（P＜0.05）。末次随访时两组之间的X/Y比值无统计学意义（P＞0.05）；末次随访时两组FPA有统计学意义[（65.6±1.9),（61.8±4.9)，P＜0.05]。［结论]与传统徒手跟骨截骨术相比，3D打印导板辅助的跟骨截骨术治疗Haglund综合征患者治疗效果更佳，同时提高了手术精度，手术时间更短，术中出血量、透视次数更少。

Abstract:

Abstract: [Objective] To explore the clinical efficacy of 3D-printed guides in assisting calcaneal osteotomy for the treatment of Haglund syndrome. [Methods] A retrospective analysis was conducted on 37 patients with Haglund syndrome admitted to our hospital from January 2021 to June 2022. Based on the communication between physicians and patients, 17 cases underwent calcaneal osteotomy assisted by 3D-printed guides (Guide group), and 20 cases underwent manual calcaneal osteotomy (Manual group). Clinical and imaging results were compared between the two groups. [Results] The Guide group exhibited significantly shorter operation time [(42.8±4.1) min vs (50.2±4.2) min, P＜0.05] and fewer postoperative fluoroscopic examinations [(0.6±0.6) times vs (50.2±4.2) times, P＜0.05] compared to the Manual group. There were no statistically significant differences between the two groups in terms of hospital stay, incision length, intraoperative blood loss, and wound healing (P＞0.05). Over time after surgery, both groups showed a significant reduction in VAS scores (P＞0.05) and a significant improvement in AOFAS scores compared to preoperative scores (P＜0.05). At the last follow-up, there was no statistically significant difference in VAS scores between the two groups (P＞0.05), but the AOFAS score in the Guide group was significantly higher than that in the Manual group [(96.5±2.9) vs (94.4±3.3), P＜0.05]. In terms of imaging, there were no statistically significant differences in Fowler-Philipp angle (FPA) and X/Y ratio between the two groups before surgery (P＞0.05). At the last follow-up, both groups showed a significant decrease in FPA and a significant increase in X/Y ratio compared to preoperative values (P＜0.05). There was no statistically significant difference in X/Y ratio between the two groups at the last follow-up (P＞0.05), but there was a statistically significant difference in FPA [(65.6±1.9) vs (61.8±4.9), P＜0.05]. [Conclusion] Compared with traditional manual calcaneal osteotomy, 3D-printed guide-assisted calcaneal osteotomy for the treatment of Haglund syndrome patients achieves better treatment outcomes, improves surgical accuracy, shortens operation time, and reduces intraoperative blood loss and fluoroscopic examinations.