TY - JOUR
T1 - 3D-printed models improve surgical planning for correction of severe postburn ankle contracture with an external fixator
AU - Chen, Youbai
AU - Niu, Zehao
AU - Jiang, Weiqian
AU - Tao, Ran
AU - Lei, Yonghong
AU - Guo, Lingli
AU - Zhang, Kexue
AU - Xia, Wensen
AU - Song, Baoqiang
AU - Huang, Luyu
AU - Zhang, Qixu
AU - Han, Yan
N1 - Publisher Copyright:
© 2021, Zhejiang University Press.
PY - 2021/10
Y1 - 2021/10
N2 - Gradual distraction with an external fixator is a widely used treatment for severe postburn ankle contracture (SPAC). However, application of external fixators is complex, and conventional two-dimensional (2D) imaging-based surgical planning is not particularly helpful due to a lack of spatial geometry. The purpose of this study was to evaluate the surgical planning process for this procedure with patient-specific three-dimension-printed models (3DPMs). In this study, patients coming from two centers were divided into two cohorts (3DPM group vs. control group) depending on whether a 3DPM was used for preoperative surgical planning. Operation duration, improvement in metatarsal-tibial angle (MTA), range of motion (ROM), the American Orthopedic Foot and Ankle Society (AOFAS) scores, complications, and patient-reported satisfaction were compared between two groups. The 3DPM group had significantly shorter operation duration than the control group ((2.0±0.3) h vs. (3.2± 0.3) h, P<0.01). MTA, ROM, and AOFAS scores between the two groups showed no significant differences pre-operation, after the removal of the external fixator, or at follow-up. Plantigrade feet were achieved and gait was substantially improved in all patients at the final follow-up. Pin-tract infections occurred in two patients (one in each group) during distraction and were treated with wound care and oral antibiotics. Patients in the 3DPM group reported higher satisfaction than those in the control group, owing to better patient-surgeon communication. Surgical planning using patient-specific 3DPMs significantly reduced operation duration and increased patient satisfaction, while providing similar improvements in ankle movement and function compared to traditional surgical planning for the correction of SPAC with external fixators.
AB - Gradual distraction with an external fixator is a widely used treatment for severe postburn ankle contracture (SPAC). However, application of external fixators is complex, and conventional two-dimensional (2D) imaging-based surgical planning is not particularly helpful due to a lack of spatial geometry. The purpose of this study was to evaluate the surgical planning process for this procedure with patient-specific three-dimension-printed models (3DPMs). In this study, patients coming from two centers were divided into two cohorts (3DPM group vs. control group) depending on whether a 3DPM was used for preoperative surgical planning. Operation duration, improvement in metatarsal-tibial angle (MTA), range of motion (ROM), the American Orthopedic Foot and Ankle Society (AOFAS) scores, complications, and patient-reported satisfaction were compared between two groups. The 3DPM group had significantly shorter operation duration than the control group ((2.0±0.3) h vs. (3.2± 0.3) h, P<0.01). MTA, ROM, and AOFAS scores between the two groups showed no significant differences pre-operation, after the removal of the external fixator, or at follow-up. Plantigrade feet were achieved and gait was substantially improved in all patients at the final follow-up. Pin-tract infections occurred in two patients (one in each group) during distraction and were treated with wound care and oral antibiotics. Patients in the 3DPM group reported higher satisfaction than those in the control group, owing to better patient-surgeon communication. Surgical planning using patient-specific 3DPMs significantly reduced operation duration and increased patient satisfaction, while providing similar improvements in ankle movement and function compared to traditional surgical planning for the correction of SPAC with external fixators.
KW - 3D printing
KW - Ankle contracture
KW - Ilizarov
KW - Postburn contracture
KW - Surgical planning
UR - http://www.scopus.com/inward/record.url?scp=85117384361&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85117384361&partnerID=8YFLogxK
U2 - 10.1631/jzus.B2000576
DO - 10.1631/jzus.B2000576
M3 - Article
C2 - 34636189
AN - SCOPUS:85117384361
SN - 1673-1581
VL - 22
SP - 866
EP - 875
JO - Journal of Zhejiang University: Science B
JF - Journal of Zhejiang University: Science B
IS - 10
ER -