Abstract

Background

Charcot neuroarthropathy of the ankle is an extremely challenging clinical dilemma, and its surgical management can be highly complicated. The goal of Charcot ankle treatment is to to restore a plantigrade and stable foot, and thus to avoid ulceration with subsequent infection. This report aims to introduce a method of correcting ankle deformity using a novel 3D printing technique.

Patient and methods

One patient with Charcot ankle deformity was operated in this study. The ankle deformity of this patient was quantified in three dimensions through computed tomography. On the basis of the computed tomography scans, a new titanium implant was designed and manufactured using 3D printing. The implant was applied in the surgery of tibio-talo-calcaneal arthrodesis to restore local anatomy of the affected ankle of the patient with Charcot neuroarthropathy.

Results

Evaluation of the post-operative radiography indicated union in the affected ankle. After surgery, the planar foot in this patient was restored. The patient was satisfied with the post-operative course, and joint fusion was successful as indicated by 2-year post-operative evaluation. The results of post-operative follow-up showed that the lower limb length of the patient with Charcot neuroarthropathy was salvaged, and the patient retained the plantigrade foot.

Conclusion

Three-dimensional printing technique combined with tibio-talo-calcaneal arthrodesis may help to correct ankle deformity in patients with Charcot neuroarthropathy.

中文翻译：

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钛种植体三维矫正Charcot踝关节畸形

摘要

背景

踝关节 Charcot 神经关节病是一个极具挑战性的临床难题，其手术治疗可能非常复杂。Charcot 踝关节治疗的目标是恢复足底稳定的足部，从而避免溃疡和随后的感染。本报告旨在介绍一种使用新型 3D 打印技术矫正踝关节畸形的方法。

患者和方法

本研究中对一名 Charcot 踝关节畸形患者进行了手术。该患者的踝关节畸形通过计算机断层扫描在三个维度上进行量化。在计算机断层扫描的基础上，使用 3D 打印设计和制造了一种新的钛植入物。该植入物用于胫骨-跟骨关节融合术，以恢复Charcot神经关节病患者受影响踝关节的局部解剖结构。

结果

术后影像学评估表明受影响的脚踝愈合。手术后，该患者的平面足得到了恢复。患者对术后过程感到满意，术后 2 年评估表明关节融合成功。术后随访结果显示，Charcot神经关节病患者的下肢长度被挽救，患者保留了跖行足。

结论

三维打印技术结合胫距跟骨关节固定术可能有助于纠正 Charcot 神经关节病患者的踝关节畸形。