Preoperative virtual iliosacral screw combined with individualized 3D printing navigation template for accurate treatment of posterior pelvic ring injury in a clinical study

Abstract

Purpose: This research introduced a novel approach that combines a Three-dimensional(3D) printed guide-plate with preoperative virtual iliosacral screws to guide the insertion of intraoperative screws, and compares its effectiveness and safety to traditional surgical procedures. Methods：59 patients in our hospital were randomized to a guide-plate group (n=30) or a traditional surgical group (n=29) after receiving percutaneous iliosacrals for unstable posterior pelvic ring injuries. Gender, age, injury mechanism, sacrum type, fracture type, time of each screw placement, radiation exposure time of each screw, and postoperative screw classification are all factors to take into account. Results: In 59 patients, a total of 83 iliosacral screw were implanted, including 43 screws in the guide-plate group (37 in S1 and six in S2) and 40 screws in the traditional surgery group (34 in S1 and six in S2). The screw dislocation rate of patients in the guide-plate group (2.3%) was considerably lower than that of the traditional surgery group (15.0%); the radiation exposure duration for each screw in the guide-plate group (0.4±0.1min) was lower than that of the traditional operation group (0.9±0.2min). The screw dislocation rate and radiation exposure time were statistically significant (P<0.05). The time it took to place each screw in the traditional surgery group (25.9±3.8min) was longer than in the guide-plate group (19.2±2.8min), although this difference was not statistically significant (p>0.05). Conclusion: Preoperative virtual screw technology combined with 3D guide technology can accurately place iliosacral screws, introducing a new option for percutaneous iliosacral screw placement.