目的:本研究旨在比较传统手术(TS)与三维模型辅助手术(3DS)在拇指外翻(HV)手术中的效果。
方法:这项随机对照试验研究包括30名患者,随机分为TS和3DS。在3DS组中,手术前在3D模型上模拟手术,该模拟在手术过程中被用作指导。各种参数,例如HV的角度,跖骨间(IM),和跖骨远端关节,在术前和最终随访期间进行测量。评估了第一meta骨(FM)头的偏侧化程度和FM头的足底位移。如截骨+侧化+K线固定的持续时间,止血带时间,并记录透视使用情况.所有评估均独立且盲目进行。患者仍然不知道他们的组分配和随机化程序。
结果:两组性别无统计学差异,操作侧,年龄,或随访持续时间。例如,在3DS组中(n=15,年龄:44.6±9.6岁,男/女:14/1,左右侧:11/4,随访时间:29.4±8.7个月),TS组(n=15,年龄:44.8±9.6岁,男/女:13/2,左右侧:10/5,随访时间:28.8±8.4个月)。3DS组,然而,截骨+侧化+K线固定显示更好的指标,止血带持续时间,以及12.4±1.2分钟时的荧光检查次数,41.5±3.8分钟,2.5±0.6倍。相比之下,TS组记录17.1±1.5分钟,50.8±3.4分钟,3.3±0.8倍,分别(所有人P<.001)。3DS组还获得了更显著的IM角恢复(P<.001)。手术后,3DS组在FM头部侧化方面表现出优异的结果,调频缩短,和足底位移(分别为P<.001、P<.001和P=.006,对于所有指标)。3DS组只有1例患者出现针道感染,用伤口护理和口服抗生素治疗。
结论:在3D模型上模拟手术并将其作为指导可显著提高手术结果。好处包括减少操作时间,止血带持续时间,减少透视使用,和改进的第一射线对齐。3DS方法还确保了第一meta头的更好的侧向化和IM的矫正。尽管3D模型辅助HV人字形截骨术提供了理想的畸形矫正,对术后功能结局无显著影响.
方法:一级,治疗研究。引用这篇文章:SüerO,厄泽玛,GovsaF,奥兹图尔克,阿克图卢SK。使用三维打印模型的手术模拟对拇指外翻手术远端人字形截骨术结果的影响:一项随机对照试验.ActaOrthopTraumatolTurc。,2024;58(2):95-101。
OBJECTIVE: This study aimed to compare the outcomes of traditional surgery (TS) with those of a 3-dimensional model-assisted surgery (3DS) in hallux valgus (HV) surgery with distal chevron osteotomy.
METHODS: This randomized controlled trial study included 30 patients randomly grouped as TS and 3DS. In the 3DS group, the surgery was simulated on the 3D model before surgery, and that simulation was used as a guide during surgery. Various parameters, such as angles of the HV, intermetatarsal (IM), and distal metatarsal articular, were measured pre-surgery and during the final follow-up. The extent of lateralization of the first metatarsal (FM) head and plantar displacement of the FM head were assessed. Metrics like the duration of the osteotomy+lateralization+K wire fixation, tourniquet time, and fluoroscopy usage were recorded. All assessments were conducted independently and blindly. Patients remained unaware of their group allocation and the randomization procedure.
RESULTS: Both groups showed no statistical differences in gender, operated side, age, or follow-up duration. For instance, in the 3DS group (n=15, age: 44.6 ± 9.6 years, male/female: 14/1, side right/left: 11/4, follow-up duration: 29.4 ± 8.7 months) and TS group (n=15, age: 44.8 ± 9.6 years, male/female: 13/2, side right/left: 10/5, follow-up duration: 28.8 ± 8.4 months). The 3DS group, however, showed better metrics with osteotomy+lateralization+K wire fixation, tourniquet duration, and number of fluoroscopies at 12.4 ± 1.2 minutes, 41.5 ± 3.8 minutes, 2.5 ± 0.6 times. In contrast, the TS group recorded 17.1 ± 1.5 minutes, 50.8 ± 3.4 minutes, and 3.3 ± 0.8 times, respectively (P <.001 for all). The 3DS group also achieved a more significant restoration of the IM angle (P < .001). Postsurgery, the 3DS group demonstrated superior outcomes in FM head lateralization, FM shortening, and plantar displacement (P <.001, P <.001 and P = .006, respectively, for all metrics). Only 1 patient in the 3DS group experienced a pin-tract infection, which was treated with wound care and oral antibiotics.
CONCLUSIONS: Simulating surgery on a 3D model and using it as a guide significantly enhances surgical outcomes. Benefits include reduced operation time, tourniquet duration, decreased fluoroscopy usage, and improved first-ray alignment. The 3DS method also ensures better lateralization of the first metatarsal head and correction of the IM. Although 3D model-assisted HV chevron osteotomy surgery provides ideal deformity correction, it does not significantly affect postoperative functional outcomes.
METHODS: Level I, Therapeutic Study. Cite this article as:Süer O, Özer MA, Govsa F, Öztürk AM, Aktuğlu SK. Impact of surgery simulation using a 3-dimensional printed model on outcomes of hallux valgus surgery with distal chevron osteotomy: A randomized controlled trial. Acta Orthop Traumatol Turc., 2024;58(2):95-101.