Discussion
fracture, fractures, swelling, necrosis
NECROSIS
Complex distal intra-articular fractures of the trimalleolar ankle involve fractures within the joint, with the ankle joint bearing weight. During surgery, achieving anatomical reduction and robust fixation are key factors for patients to achieve a good recovery. In most patients, there is swelling in the affected limb, and the condition of the soft tissues is often poor. Performing surgery hastily during the swelling stage may worsen the swelling, affect blood circulation at the site, and increase the risk of muscle soft tissue necrosis and infectionThis study indicates that the personalized plate group had slightly longer preoperative preparation and hospitalization times compared to the conventional plate group, and the difference was statistically significant. This may be influenced by the preoperative printing of 3D models and customized plates. With the development of printing and customization technologies, researchers believe that the waiting time in this regard will likely decrease in the futureIn recent years, the application of 3D printing technology in orthopedics has become increasingly widespread. By 3D printing fracture models, patients and physicians can obtain more intuitive and three-dimensional fracture information, allowing for more comprehensive preoperative planning and simulation. Related studies also indicate that 3D printing technology-assisted fracture surgery, compared to traditional surgery, results in better surgical outcomes and higher satisfaction among both doctors and patientsHowever, the combined use of 3D printing technology and personalized custom-made plates still faces two significant "stubborn" challenges: firstly, the cost of custom-made plates is high, with substantial expenses associated with 3D printing equipment, printing materials, and material requirements (including biocompatibility and degradability)The limitations of this study include the small sample size of only 48 cases and the lack of long-term follow-up of 3–5 years. These factors could introduce some bias into the results. It is hoped that future high-quality studies with larger and more diverse samples will provide more comprehensive and accurate conclusions.