Effect observation of 3D printing adjuvant therapy in treatment of patients with posterior Pilon fracture after treatment

Objective To observe the clinical effect of 3D printing adjuvant therapy in treatment of patients with posterior Pilon fracture after treatment.

Methods The clinical materials of 92 patients with posterior Pilon fracture from January 2012 to December 2020 in the Department of Orthopedics of Liyang People′s Hospital were retrospectively analyzed. Among them, 47 patients with preoperative 3D printing for simulating operation were selected as 3D printing group, and 45 patients without 3D printing for simulating operation were selected as control group. The operation related complications were recorded in both groups, and the operation time, intraoperative X-ray fluoroscopy times, condition of surgical reduction, clinical healing time of fractures, the score of ankle scoring system of the American College of Foot and Ankle Surgeons (AOFAS) and the score of Visual Analogue Scale (VAS) of ankle pain at the last follow-up were compared between the two groups.

Results All the patients were followed up for 12 to 20 months. All the patients achieved primary healing after operation, and no patient had complications such as incision infection, skin necrosis, deep venous thrombosis of lower limbs, and checkrein deformity of toes. The operation time and intraoperative fluoroscopy times in the 3D printing group were (81.4±9.4) min and (13.0±2.3) times respectively, which were significantly shorter and less than (94.9±11.6) min and (18.4±3.2) times in the control group (P < 0.05). In the control group, there were 3 cases with poor reduction of posterior malleolus fracture, but there were no patients with poor reduction of posterior malleolus fracture in the 3D printing group, and there was no significant difference between two groups (P>0.05). The fracture healing time, postoperative AOFAS score and VAS score in the 3D printing group were (12.9±1.0) weeks, (92.8±4.2) points and (1.1±0.8) points respectively, while were (13.2±1.3) weeks, (90.8±4.5) points and (1.3±0.8) points respectively in the control group, and there were no significant differences between two groups (P>0.05).

Conclusion Application of 3D printing adjuvant therapy can optimize the operation plan of posterior Pilon fracture, shorten the operation time, reduce the number of intraoperative fluoroscopy, and achieve individualized precision treatment.