目的:系统评价旨在确定使用3D打印辅助术前计划的价值,与传统规划相比,用于足踝骨折的手术治疗。
方法:根据PRISMA指南进行系统评价。两位作者在三个电子数据库上进行了搜索。如果研究符合预先建立的资格标准,则将其包括在内。主要结果指标包括术中失血,操作持续时间,和透视时间。美国骨科足踝评分(AOFAS)被用作次要结果。使用CochraneRoB2表格完成质量评估,并进行荟萃分析以评估异质性。
结果:5项研究符合纳入和排除标准,最终被纳入综述。一项荟萃分析确定,使用3D打印模型进行术前计划可显著缩短手术时间(平均差异[MD]=-23.52分钟,95%CI[-39.31,-7.74],p=0.003),术中失血(MD=-30.59mL,95%CI[-46.31,-14.87],p=0.0001),和使用透视的次数(MD=-3.20次,95%CI[-4.69,-1.72],p<0.0001)。使用3D打印模型也显着增加了AOFAS评分结果(MD=2.24,95%CI[0.69,3.78],p=0.005),证明改善脚踝健康。
结论:系统评价提供了有希望的证据,表明3D打印辅助手术在手术持续时间方面显着改善了足部和踝关节骨折的治疗。术中失血,术中使用透视的次数,通过AOFAS评分测量,改善了整体踝关节健康。
OBJECTIVE: The systematic
review aims to establish the value of using 3D printing-assisted pre-operative planning, compared to conventional planning, for the operative management of foot and ankle fractures.
METHODS: The systematic
review was performed according to PRISMA guidelines. Two authors performed searches on three electronic databases. Studies were included if they conformed to pre-established eligibility criteria. Primary outcome measures included intraoperative blood loss, operation duration, and fluoroscopy time. The American orthopaedic foot and ankle score (AOFAS) was used as a secondary outcome. Quality assessment was completed using the Cochrane RoB2 form and a meta-analysis was performed to assess heterogeneity.
RESULTS: Five studies met the inclusion and exclusion criteria and were eventually included in the
review. A meta-analysis established that using 3D printed models for pre-operative planning resulted in a significant reduction in operation duration (mean difference [MD] = - 23.52 min, 95% CI [- 39.31, - 7.74], p = 0.003), intraoperative blood loss (MD = - 30.59 mL, 95% CI [- 46.31, - 14.87], p = 0.0001), and number of times fluoroscopy was used (MD = - 3.20 times, 95% CI [- 4.69, - 1.72], p < 0.0001). Using 3D printed models also significantly increased AOFAS score results (MD = 2.24, 95% CI [0.69, 3.78], p = 0.005), demonstrating improved ankle health.
CONCLUSIONS: The systematic
review provides promising evidence that 3D printing-assisted surgery significantly improves treatment for foot and ankle fractures in terms of operation duration, intraoperative blood loss, number of times fluoroscopy was used intraoperatively, and improved overall ankle health as measured by the AOFAS score.