Objective To review the current research progress of three-dimensional (3-D) printing technique in foot and ankle surgery. Methods Recent literature associated with the clinical application of 3-D printing technique in the field of medicine, especially in foot and ankle surgery was reviewed, summarized, and analyzed. Results At present, 3-D printing technique has been applied in foot and ankle fracture, segmental bone defect, orthosis, corrective surgery, reparative and reconstructive surgery which showed satisfactory effectiveness. Currently, there are no randomized controlled trials and the medium to long term follow-up is necessary. Conclusion The printing materials, time, cost, medical ethics, and multi-disciplinary team restricted the application of 3-D printing technique, but it is still a promising technique in foot and ankle surgery.
ObjectiveTo compare the early effectiveness of minimally invasive open reduction and internal fixation via posterior median approach versus arthroscopic double-tunnel suture fixation in treatment of tibial avulsion fracture of the posterior cruciate ligament (PCL).MethodsA clinical data of 31 patients with the tibial avulsion fracture of the PCL and met the criteria between January 2015 and January 2019 was retrospectively analyzed. Nineteen patients (group A) were treated with open reduction and internal fixation with cannulated screw via posterior median approach. The other 12 patients (group B) were treated with arthroscopic double-tunnel suture fixation technique. There was no significant difference between the two groups (P>0.05) in the gender, age, side of effected limb, the injury cause, the time from injury to operation, the combined meniscus injury, Meyers & McKeever classification and preoperative Lysholm score, Tegner score, International Knee Documentation Committee (IKDC) score, and the difference of tibial posterior displacement between bilateral knees. The operation time, postoperative complications, fracture healing, and the difference of tibial posterior displacement between bilateral knees, Lysholm score, Tegner score, and IKDC score were recorded.ResultsGroup B spent significantly longer operation time than group A (t=7.347, P=0.000). No postoperative complication occurred in group B, and 1 patient in group A had a screw breakage. All patients were followed up 6-36 months (mean, 22 months). X-ray films showed that all fractures healed at 3 months after operation. At last follow-up, there was no significant difference in the patients with normal knee range of motion between the two groups (P=0.510). At last follow-up, the difference of tibial posterior displacement between bilateral knees, Lysholm score, Tegner score, and IKDC score in the two groups were superior to those before operation (P<0.05); while there was no significant difference between the two groups (P>0.05).ConclusionFor the tibial avulsion fracture of PCL, the minimally invasive open reduction and internal fixation and arthroscopic double-tunnel suture fixation can obtain similar early effectiveness. However, arthroscopic surgery has the advantages of being able to simultaneously deal with intra-articular combined injuries, avoiding internal fixator complications, and eliminating the need for secondary operation.
目的 了解依托芬那酯凝膠對有疼痛癥狀的輕中度拇外翻畸形的治療效果。 方法 對2010年3月－2011年7月門診收治的輕中度拇外翻患者共65足，隨機分成兩組，治療組采取托芬那酯凝膠局部應用和佩戴夜間支具，對照組佩戴夜間支具，局部應用安慰劑，治療周期1個月。記錄癥狀明顯緩解時間，治療前后對患者進行視覺模擬疼痛評分和美國骨科足踝分會跖趾及趾間關節評分，并測量拇外翻角和第一跖骨間角改變。 結果 全部患者完成治療，疼痛緩解時間治療組為（3.28 ± 1.04）d，對照組（7.03 ± 2.15）d，差異有統計學意義（P＜0.05）,佩戴足矯形器治療1個月，拇外翻角和第一跖骨間角改變無統計學差異（P＞0.05）。 結論 局部應用依托芬那酯凝膠結合足矯形器治療輕中度拇外翻能快速緩解疼痛癥狀，改善活動能力，延緩畸形加重，依托芬那酯凝膠局部給藥患者能良好耐受，可避免口服非甾體抗炎藥（NSAIDs）帶來的副作用。