Objective: This comparative cohort study evaluates the clinical efficacy of 3D-printed patient-specific cutting guides (PSCGs) versus conventional manual techniques in correcting rigid midfoot pes cavus deformities.

Methods: A retrospective analysis of 40 patients (80 feet) undergoing Cole osteotomy between 2021 and 2023 was conducted. Patients were stratified into two matched cohorts: Group A (manual osteotomy, n = 20) and Group B (PSCG-assisted, n = 20). Radiographic parameters (Meary's angle, TMI, TCA, Djian-Annonier angle, Pitch angle) and functional outcomes (VAS, AOFAS, SF-36) were analyzed preoperatively and at mean 17-month follow-up. Surgical metrics including operative time, fluoroscopy frequency, and complication rates were systematically compared.

Results: Radiographic analysis demonstrated superior angular correction in the PSCG-assisted cohort versus conventional osteotomy, with significantly improved bilateral Meary's angle (Right: 1.94°±0.62 vs. 6.04°±2.20, P < 0.05; Left: 1.62°±0.54 vs. 6.39°±2.04, P < 0.05) and TMI angle (Right: 4.32°±3.14 vs. 8.51°±8.12, P < 0.05; Left: 4.74°±2.44 vs. 8.53°±5.93, P < 0.05). The PSCG technique achieved equivalent correction in TCA, Djian-Annonier, and Pitch angles while demonstrating enhanced consistency (38-66% reduction in standard deviations). Functionally, PSCG-assisted procedures yielded superior AOFAS scores (97.71 ± 0.77 vs. 92.07 ± 2.25, Δ = 5.64 [95%CI 4.54-6.74], P < 0.05) and SF-36 outcomes, particularly in general health (Δ = 16.96, P < 0.05) and mental well-being (Δ = 7.92, P = 0.001). Operative metrics favored PSCG with 36% shorter procedure time (82.9 ± 13.9 vs. 129.0 ± 39.6 min, P < 0.05) and 77% reduced intraoperative fluoroscopy (4.65 ± 1.06 vs. 20.07 ± 2.92 exposures, P < 0.05). No surgical site infections occurred in the PSCG group versus one superficial SSI in controls CONCLUSION: 3D-printed PSCGs provide anatomically precise, efficient correction of complex midfoot deformities while minimizing intraoperative radiation exposure, establishing this technology as a safe and reproducible alternative to conventional techniques.

Keywords: 3D printing; Complex foot deformity correction; Low-radiation orthopaedics; Personalized surgical navigation; Pes cavus.

© 2025. The Author(s) under exclusive licence to SICOT aisbl.

目标: 本项比较队列研究评估了3D打印的患者特定切割导板（PSCGs）与传统手动技术在纠正rigid midfoot pes cavus畸形方面的临床疗效。

方法: 回顾性分析2021年至2023年间接受Cole骨切开术的40名患者（80只脚）。将患者分为两个匹配队列：A组（手动骨切开，n=20）和B组（PSCG辅助，n=20）。放射学参数（Meary角、TMI、TCA、Djian-Annonier角、Pitch角）以及功能结果（VAS、AOFAS、SF-36）在术前及平均17个月随访时进行分析。系统比较了手术指标，包括手术时间、透视次数和并发症发生率。

结果: 放射学分析表明，在PSCG辅助队列中与传统骨切开相比，角矫正效果更佳，两者的Meary角（右：1.94°±0.62 vs 6.04°±2.20, P

关键词: 3D打印；复杂足部畸形矫正；低辐射骨科手术；个性化外科导航；pes cavus。