基于3D打印技术的数字化支具固定在母外翻微创截骨手法整复术中的应用效果

孙世栋, 黄杰文, 王斌

中国临床解剖学杂志 ›› 2026, Vol. 44 ›› Issue (4) : 448-455.

PDF(2253 KB)
PDF(2253 KB)
中国临床解剖学杂志 ›› 2026, Vol. 44 ›› Issue (4) : 448-455. DOI: 10.13418/j.issn.1001-165x.2026.4.12
临床研究

基于3D打印技术的数字化支具固定在母外翻微创截骨手法整复术中的应用效果

  • 孙世栋,    黄杰文*,    王斌
作者信息 +

Application effect of digital support fixation based on 3D printing technology in minimally invasive osteotomy and reconstruction of hallux valgus

  • Sun Shidong, Huang Jiewen*, Wang Bin
Author information +
文章历史 +

摘要

目的    探讨基于3D打印技术的数字化支具固定联合微创截骨手法整复术治疗母外翻(HAV)的效果。 方法    选取于2023年6月~2024年11月广州中医药大学第三附属医院收治的HAV患者作为研究对象,回顾性依据固定方法的不同按照1:1比例纳入A组和B组各39例,共78例。A组给予常规固定,B组给予基于3D打印技术的数字化支具固定。两组术后均随访6个月。比较两组治疗优良率、疼痛、足踝功能及影像学指标及并发症。  结果    术后3、6个月,B组视觉模拟量表(VAS)评分更低(P<0.05)。术后6个月,B组足踝功能评分更高,外翻角(HVA)、第1、2跖骨间角(IMA)、跖骨远端关节角(DMAA)更低,第一跖骨长度更长(P<0.05)。  结论    基于3D打印技术的数字化支具固定对HAV患者微创截骨手法整复术的治疗效果无明显影响,可能可减轻疼痛、改善影像学指标、提高足踝功能,安全性良好。

Abstract

Objective   To explore the effect of digital support fixation combined with minimally invasive osteotomy technique based on 3D printing technology for the treatment of hallux valgus (HAV).   Methods   HAV patients admitted to the Third Affiliated Hospital of Guangzhou University of Chinese Medicine from June 2023 to November 2024 were selected as the research subjects. A retrospective analysis was conducted, and patients were divided into the group A and the group B in a 1:1 ratio based on different fixed methods, with 39 cases in each group, for a total of 78 cases. The patients of group A received conventional fixation, while the patients of group B received brace fixation based on 3D printing technology. Both groups of patients were followed up for 6 months after surgery. The excellent and good rate, pain levels, ankle function and radiographic indicators, as well as complications of two groups were compared.    Results    At 3 and 6 months after surgery, the visual analog scale (VAS) scores of the patients in group B were lower (P<0.05). At 6 months after surgery, the ankle function scores in the patients in group B was higher; The hallux valgus angle (HVA), first and second metatarsal angles (IMA), and distal metatarsal articular angle (DMAA) were lower. The length of the first metatarsal bone was longer (P<0.05).    Conclusions    The use of 3D printing technology-based braces for fixation had no significant impact on the therapeutic effect of minimally invasive osteotomy technique and manual reduction for patients with HAV. However, it might help to alleviate pain, improve imaging indicators, enhance ankle function, and have good safety and good safety.

关键词

微创截骨手法整复术;  /   / 3D打印技术;  /   / 支具固定;  /  母外翻;  /   / 疼痛;  /   / 足踝功能

Key words

Minimally invasive osteotomy technique and manual reduction;  /   / 3D printing technology / Brace fixation;  /   / Hallux valgus;  /   / Pain;  /   / Ankle and foot function

引用本文

导出引用
孙世栋, 黄杰文, 王斌. 基于3D打印技术的数字化支具固定在母外翻微创截骨手法整复术中的应用效果[J]. 中国临床解剖学杂志. 2026, 44(4): 448-455 https://doi.org/10.13418/j.issn.1001-165x.2026.4.12
Sun Shidong, Huang Jiewen, Wang Bin. Application effect of digital support fixation based on 3D printing technology in minimally invasive osteotomy and reconstruction of hallux valgus[J]. Chinese Journal of Clinical Anatomy. 2026, 44(4): 448-455 https://doi.org/10.13418/j.issn.1001-165x.2026.4.12
中图分类号: R684.3    R322.71   

参考文献

[1]  Ying J, Xu Y, István B, et al. Adjusted indirect and mixed comparisons of conservative treatments for hallux valgus: a systematic review and network meta-analysis[J]. Int J Environ Res Public Health, 2021, 18(7): 3841. DOI: 10.3390/ijerph18073841.
[2]  Do DH, Sun JJ, Wukich DK. Modified lapidus procedure and hallux valgus: a systematic review and update on triplanar correction[J]. Orthop Clin North Am, 2022, 53(4): 499-508. DOI: 10.1016/j.ocl.2022.05.005.
[3]  Zaidi R, Lewis TL, Ray R. The role of minimally invasive osteotomies in cavovarus foot reconstruction: detailed technique and evidence for procedures[J]. Foot Ankle Clin, 2023, 28(4): 709-718. DOI: 10.1016/j.fcl.2023.05.002.
[4]  Rougereau G, Marty-Diloy T, Rougereau G, et al. Litigation after hallux valgus surgery in france between 2000 and 2020: a review of the two national legal research databases[J]. Foot Ankle Surg, 2022, 28(4): 497-502. DOI: 10.1016/j.fas.2022.01.004.
[5]  谢飞, 常程, 温建民, 等. 拇外翻足有限元模型建立及“裹帘”外固定下的生物力学分析[J]. 中华中医药杂志,  2020, 35(3): 1559-1563. DOI: 10.13268/j.cnki.chinajtcm.2020.03.1559
       Xie F, Chang C, Wen JM, et al. Establishment of finite element model for hallux valgus foot and biomechanical analysis under external fixation with "wrap curtain" [J]. Chinese Journal of Traditional Chinese Medicine, 2020, 35 (3): 5. DOI:10.13268/j.cnki.chinajtcm.2020.03. 1559
[6] Kumar Gupta D, Ali MH, Ali A, et al. 3D printing technology in healthcare: applications, regulatory understanding, IP repository and clinical trial status[J]. J Drug Target, 2022, 30(2): 131-150. DOI: 10.1080/1061186X.2021.1935973.
[7]  刘航, 祁峰, 刘德成. Ludloff截骨术和Chevron截骨术治疗母外翻畸形疗效对比[J]. 中国美容医学, 2023, 32(2): 60-63. DOI: 10.7531/j.issn.1672-9935.2020.12.033.
      Liu H, Qi F, Liu DC. Comparison of the therapeutic effects of Ludloff osteotomy and Chevron osteotomy in the treatment of hallux valgus deformity [J]. Chinese Journal of Aesthetic Medicine, 2023, 32 (2): 60-63. DOI: 10.7531/j.issn. 1672-9935.2020.12.033.
[8] Lewis TL, Lau B, Alkhalfan Y, et al. Fourth-generation minimally invasive hallux valgus surgery with metaphyseal extra-articular transverse and akin osteotomy (meta): 12 month clinical and radiologic results[J]. Foot Ankle Int, 2023, 44(3): 178-191. DOI: 10.1177/10711007231152491.
[9]  中华医学会骨科学分会足踝外科学组,中国医师协会骨科医师分会足踝外科专业委员会. 母外翻诊疗专家共识[J]. 中国医学前沿杂志(电子版), 2017, 9(10): 30-42. DOI: 10.12037/YXQY.2017.10-06.
       The Foot and Ankle Surgery Group of the Orthopedic Branch of the Chinese Medical Association, and the Foot and Ankle Surgery Professional Committee of the Orthopedic Branch of the Chinese Medical Association. Expert consensus on the diagnosis and treatment of hallux valgus [J]. Chinese Journal of Medical Frontiers (Electronic Edition), 2017, 9 (10): 30-42. DOI: 10.12037/YXQY.2017.10-06.
[10]及松洁, 杜辉, 张纪, 等.  Scarf联合Akin手术治疗中重度拇外翻的疗效[J]. 实用医学杂志, 2020, 36(20): 2885-2888. DOI: 10.3969/j.issn.1006-5725.2020.20.029.
       JiSJ, Du H, Zhang J, et al. The efficacy of Scarf combined with Akin surgery in the treatment of moderate to severe hallux valgus [J]. Journal of Practical Medicine, 2020, 36(20): 2885-2888. DOI: 10.3969/j.issn.1006-5725.2020.20.029.
[11]Britto-Júnior J, da Silva-Filho WP, Amorim AC, et al. 6-nitrodopamine is a major endogenous modulator of human vas deferens contractility[J]. Andrology, 2022, 10(8): 1540-1547. DOI: 10.1111/andr.13263.
[12]Hernández-Castillejo LE, Álvarez-Bueno C, Garrido-Miguel M, et al. The effect of hallux valgus open and percutaneous surgery on AOFAS scale: a systematic review and meta-analysis[J]. Qual Life Res, 2021, 30(4): 957-966. DOI: 10.1007/s11136-020-02715-y.
[13]Miranda MAM, Martins C, Cortegana IM, et al. Complications on percutaneous hallux valgus surgery: a systematic review[J]. J Foot Ankle Surg, 2021, 60(3): 548-554. DOI: 10.1053/j.jfas.2020.06.015.
[14]Bu P, Li C, Pu L, et al. Radiographic assessment of relationship between medial cuneiform obliquity and hallux valgus[J]. J Foot Ankle Surg, 2023, 62(3): 583-589. DOI: 10.1053/j.jfas.2022.06.009.
[15]Migliorini F, Eschweiler J, Tingart M, et al. Revision surgeries for failed hallux valgus correction: a systematic review[J]. Surgeon, 2021, 19(6): 497-506. DOI: 10.1016/j.surge.2020.11.010.
[16]Graf A, Wendler D, Court T, et al. Acute clavicle fixation after blunt chest trauma: effect on pulmonary outcomes and patient disposition[J]. Eur J Orthop Surg Traumatol, 2023, 33(5): 1921-1927. DOI: 10.1007/s00590-022-03368-y.
[17]Whittaker D, Edmunds C, Scott I, et al. Rib fracture fixation in a patient on veno-venous ECMO for severe blunt thoracic trauma[J]. Ann R Coll Surg Engl, 2021, 103(9): 269-271. DOI: 10.1308/rcsann.2020.7108.
[18]Gutteck N, Ulbricht M, Delank KS, et al. Minimally invasive hallux valgus correction with internal hallux fixator - a comparative cadaver study[J]. Foot Ankle Surg, 2022, 28(3): 378-383. DOI: 10.1016/j.fas.2021.05.002.
[19]Franco H, Williamson F, Manzanero S, et al. Clavicle fixation to reduce short-term analgesia and improve respiratory function in patients with chest wall injuries[J]. Arch Orthop Trauma Surg, 2023, 143(11): 6561-6567. DOI: 10.1007/s00402-023-04952-5.
[20]Huang Q, Xu YB, Ren C, et al. Bone transport combined with bone graft and internal fixation versus simple bone transport in the treatment of large bone defects of lower limbs after trauma[J]. BMC Musculoskelet Disord, 2022, 23(1): 157. DOI: 10.1186/s12891-022-05115-0.
[21]白子兴, 曹旭含, 孙承颐, 等.  微创治疗拇外翻术后绷带外固定:有限元分析截骨端稳定性[J]. 中国组织工程研究, 2020, 24(18): 2811-2816. DOI: 10.3969/j.issn.2095-4344.2666.
      Bai ZX, Cao XH, Sun CY, et al. Minimally invasive treatment of external fixation of bandage after hallux valgus surgery: finite element analysis of stability of osteotomy end [J]. Chinese Journal of Tissue Engineering Research, 2020, 24(18): 2811-2816. DOI: 10.3969/j.issn.2095-4344.2666.
[22]Rogol EV. External fixation for tissue preservation following complex mandible trauma and its sequelae: reminder of a time-honored method and case series of 23 patients[J]. Oral Surg Oral Med Oral Pathol Oral Radiol, 2025, 139(5): 501-508. DOI: 10.1016/j.oooo.2024.10.113.
[23]Gaurav, Hasan N, Malik AK, et al. Recent update of 3d printing technology in pharmaceutical formulation development[J]. J Biomater Sci Polym Ed, 2021, 32(17): 2306-2330. DOI:10.1080/09205063.2021. 1967702.
[24]Della Bona A, Cantelli V, Britto VT, et al. 3d printing restorative materials using a stereolithographic technique: a systematic review[J]. Dent Mater, 2021, 37(2): 336-350. DOI: 10.1016/j.dental.2020.11.030.
[25]姚鸣宇, 朱赫, 董亦直, 等. 施罗斯PSSE联合3D打印支具治疗青少年特发性脊柱侧弯的疗效[J]. 实用医学杂志, 2024, 40(17): 2440-2447. DOI: 10.3969/j.issn.1006-5725.2024.17.015.
      Yao MY, Zhu H, Dong YZ, et al. The efficacy of Schroder PSSE combined with 3D printed braces in the treatment of adolescent idiopathic scoliosis [J]. Journal of Practical Medicine, 2024, 40 (17): 2440-2447. DOI: 10.3969/j.issn.1006-5725.2024.17.015.
[26]Zhao T, Chen H, Jia B, et al. Application of 3d printing navigation template technology in severe hallux valgus surgery[J]. J Musculoskelet Neuronal Interact, 2023, 23(4): 448-455. DOI: 10.1007/s00784-023-04983-7.
[27]Balhaddad AA, Garcia IM, Mokeem L, et al. Three-dimensional (3d) printing in dental practice: applications, areas of interest, and level of evidence[J]. Clin Oral Investig, 2023, 27(6): 2465-2481. DOI: 10.1007/s00784-023-04983-7.
[28]Chen Y, Qian C, Shen R, et al. 3d printing technology improves medical interns' understanding of anatomy of gastrocolic trunk[J]. J Surg Educ, 2020, 77(5): 1279-1284. DOI: 10.1016/j.jsurg.2020.02.031.
[29]Ahmadzadeh S, Lenie MDR, Mirmahdi RS, et al. Designing future foods: harnessing 3d food printing technology to encapsulate bioactive compounds[J]. Crit Rev Food Sci Nutr, 2025, 65(2): 303-319. DOI: 10.1080/10408398.2023.2273446.
[30]杨云霄, 赵宇, 王明海, 等. 3D打印个性化颈椎矫形支具可缓解和治疗早期颈椎病[J].  中国组织工程研究, 2024, 28(29): 4639-4644. DOI: 10.12307/2024.569.
      Yang YX, Zhao Y, Wang MH, et al. 3D printed personalized cervical orthopedic braces can alleviate and treat early cervical spondylosis [J]. Chinese Journal of Tissue Engineering Research, 2024, 28(29): 4639-4644. DOI: 10.12307/2024.569.
[31]Jiao Y, Džeroski S, Jurca A. Analysis of hallux valgus angles automatically extracted from 3d foot scans taken in north America, Europe, and Asia[J]. Ergonomics, 2023, 66(8): 1164-1175. DOI: 10.1080/00140139.2022.2139415.

基金

广东省中医药局科研项目(20241153);中华中医药学会足踝疾病科研专项课题(CACM-2025-GSKY03-B6)

PDF(2253 KB)

Accesses

Citation

Detail

段落导航
相关文章

/