Minimally invasive screw and locking plate fixation for ankle fracture based on three-dimensional print model / 中国组织工程研究

ABSTRACT

BACKGROUND:Clinical physicians should pay attention on how to reduce ankle fracture healing wounds, reduce bleeding, improve operating technique, and improve repair effect, especialy for comminuted fracture. It is necessary to understand how to develop a detailed plan before repair, observe specific circumstances of the fracture from multiple angles, and establish three-dimensional images using two-dimensional X-ray films or CT scan. These raise a chalenge for each physician. OBJECTIVE:To explore the application effect of three-dimensional print, minimaly invasive percutaneous screw and locking plate fixation in the repair of ankle fractures. METHODS: A total of 26 cases of fracture of ankle joint were treated from January 2012 to June 2014. There were 9 cases of double ankle fracture, 12 cases of three ankle fractures, and 5 cases of three ankle fractures involved PILON fracture on the lower tibia. They received spiral CT scanning on the ankle joint, and stored in the format of di.com. After processing with minics software, data were converted into STL format, and then input into the three-dimensional printer. Thus, models of ankle joint were made at the ratio of 11. The repair scheme was made. After discharge, X-ray films were checked every month to observe the healing condition of fractures. According to Mazur ankle score standard, ankle joint function was assessed. RESULTS AND CONCLUSION: Al 26 cases were folowed up for 6-12 months. The fractures were healed. The healing time was 4-6 months, averagely 5.5 months. The healing was good, without vascular and nerve damage, or plate breakage. In accordance with the Mazur ankle score standard, there were excelent in 11 cases, good in 13 cases with an excelent and good rate of 92%. The operation time was (64±15) minutes, and intraoperative blood loss was (100±15) mL. The incision was healed in stage one. These findings confirm that the simulation training and operation in fracture models of three-dimensional print have smal injuries to patients with ankle fracture. The bleeding was less, the operation was simple, the healing time was short, and the functional recovery was rapid, especialy for comminuted fracture.