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.
目的 了解依托芬那酯凝胶对有疼痛症状的轻中度拇外翻畸形的治疗效果。 方法 对2010年3月－2011年7月门诊收治的轻中度拇外翻患者共65足，随机分成两组，治疗组采取托芬那酯凝胶局部应用和佩戴夜间支具，对照组佩戴夜间支具，局部应用安慰剂，治疗周期1个月。记录症状明显缓解时间，治疗前后对患者进行视觉模拟疼痛评分和美国骨科足踝分会跖趾及趾间关节评分，并测量拇外翻角和第一跖骨间角改变。 结果 全部患者完成治疗，疼痛缓解时间治疗组为（3.28 ± 1.04）d，对照组（7.03 ± 2.15）d，差异有统计学意义（P＜0.05）,佩戴足矫形器治疗1个月，拇外翻角和第一跖骨间角改变无统计学差异（P＞0.05）。 结论 局部应用依托芬那酯凝胶结合足矫形器治疗轻中度拇外翻能快速缓解疼痛症状，改善活动能力，延缓畸形加重，依托芬那酯凝胶局部给药患者能良好耐受，可避免口服非甾体抗炎药（NSAIDs）带来的副作用。
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.