The beneficial application of preoperative 3D printing for surgical stabilization of rib fractures

Chen, Yingyi; Lin, Kuan-Hsun; Huang, Hsu-Kai; Chang, Hong-Yeh; Huang, Tsai-Wang

doi:10.1371/journal.pone.0204652

Cited by 20 publications

(7 citation statements)

References 14 publications

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“…Under the full protection of muscles and neurovasculature, the “frame” structure was successfully established with completed reduction and fixation of each middle fracture section, allowing to reduce the steps of routine surgery on rib fractures and insert and temporarily fix the locking plates. The application of 3D printing and internal fixation technology reduced the operation time and difficulty of the procedure, which were consistent with other studies [ 11 ]. Therefore, the combination of 3D printing technology and framework fixation suggested the well-fixed rib fractures, well-fitted locking plate, and decreased probability of postoperative dislocation and screw shedding.…”

Section: Discussionsupporting

confidence: 91%

Application of 3D printing and framework internal fixation technology for high complex rib fractures

Zhou

Zhang

Xie

et al. 2021

J Cardiothorac Surg

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Objective To explore the clinical effect of 3D printing combined with framework internal fixation technology on the minimally invasive internal fixation of high complex rib fractures. Methods Total 16 patients with high complex rib fractures were included in the study. Before the procedure, the 3D rib model was reconstructed based on the thin-layer chest CT scan. According to the 3D model, the rib locking plate was pre-shaped, and the preoperative planning were made including the direction of the locking plate, the location of each nail hole and the length of the screw. During the operation, the locking plate was inserted from the sternum to the outermost fracture lines of ribs with screws at both ends. In addition, the locking plate was used as the frame to sequentially reduce the middle fracture segment and fix with screws or steel wires. Chest x-rays or chest CT scans after surgery were used to assess the ribs recovery. All patients were routinely given non-steroidal anti-inflammatory drugs (NSAIDS) for analgesia, and the pain level was evaluated using numerical rating scale (NRS). Results The preoperative planning according to the 3D printed rib model was accurate. The reduction and fixation of each fracture segment were successfully completed through the framework internal fixation technology. No cases of surgical death, and postoperative chest pain was significantly alleviated. Five to 10 months follow up demonstrated neither loosening of screws, nor displacement of fixtures among patients. The lungs of each patients were clear and in good shape. Conclusion The application of 3D printing combined with framework internal fixation technology to the high complex rib fractures is beneficial for restoring the inherent shape of the thoracic cage, which can realize the accurate and individualized treatment as well as reduces the operation difficulty.

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Section: Discussionsupporting

confidence: 91%

Application of 3D printing and framework internal fixation technology for high complex rib fractures

Zhou

Zhang

Xie

et al. 2021

J Cardiothorac Surg

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“…Seven papers, i.e., 23.33% of all included studies, are retrospective non-randomized series of cases [ 19 , 20 , 23 , 24 , 28 , 29 , 38 ]. In these papers, 3D prints were used as templates for plate precontouring for 128 patients out of 233 patients surgically treated.…”

Section: Resultsmentioning

confidence: 99%

“…This 3D-printed replica is used for pre-contouring the plate by assuming body symmetry [ 16 , 17 , 18 , 20 , 21 , 22 , 25 , 27 , 28 , 35 , 36 , 37 , 38 , 39 , 40 ]; Virtual model of injured bone/zone is reconstructed and then 3D-printed. Surgeons use this tangible model to perform reduction and then to pre-contour the plate [ 13 , 14 , 15 , 19 , 29 , 33 , 41 ];…”

Section: Resultsmentioning

confidence: 99%

A Review on 3D-Printed Templates for Precontouring Fixation Plates in Orthopedic Surgery

Marinescu

Popescu

Lăptoiu

2020

JCM

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This paper is a systematic review of the literature on 3D-printed anatomical replicas used as templates for precontouring the fixation plates in orthopedic surgery. Embase, PubMed, Cochrane, Scopus and Springer databases were consulted for information on design study, fracture anatomical location, number of patients, surgical technique, virtual modeling approach and 3D printing process. The initial search provided a total of 496 records. After removing the duplicates, the title and abstract screening, and applying exclusion criteria and citations searching, 30 papers were declared eligible and included in the final synthesis. Seven studies were identified as focusing on retrospective non-randomized series of clinical cases, while two papers presented randomized case control studies. Two main approaches were highlighted in developing 3D-printed anatomical models for precontouring fixation plates: (a.) medical reconstruction, virtual planning and fracture reduction followed by 3D printing the model; (b.) medical reconstruction followed by 3D printing the model of the mirrored uninjured side. Revised studies reported advantages such as surgical time and blood loss reduction, while the reduction quality is similar with that of the conventional surgery. During the last couple of years there was an increase in the number of studies focused on precontouring orthopedic plates using 3D printing technology. Three-dimensionally-printed templates for plate precontouring were mostly used for acetabular fractures. Knowledge on medical virtual modeling and reconstruction is mandatory.

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“…There are limited reports on SSRF in patients with underlying AD. A recent case series included a patient with a traumatic Stanford Type B AD who had undergone a SSRF [ 12 ]. However, the case presented in this paper is the first report of a patient undergoing SSRF with a fracture in proximity to a known chronic Stanford type A AD.…”

Section: Introduction and Literature Reviewmentioning

confidence: 99%

Surgical Stabilisation of Traumatic Rib Fractures with Chronic, Residual Type A Aortic Dissection

2021

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Surgical stabilisation of rib fractures (SSRF) reduces morbidity and mortality. However, its impact in complicated cases, particularly those with underlying thoracic pathologies, is of continued interest. Electronic records were retrospectively reviewed after obtaining informed consent from the patient. This case report details a patient with chronic, residual, Stanford Type A aortic dissection (AD) who had multiple left-sided rib fractures with a flail segment after being struck by a bicycle. The preoperative computed tomography (CT) of the patient’s chest showed that the sixth posterior rib fracture location was just ~13 mm from the false lumen of the aorta. As the patient had poor respiratory output and persistent pain, SSRF was not performed on the posterior sections. However, the anterior third to seventh rib fractures were plated. The patient recovered fully, with reduced pain and improved respiratory function. This is the first report describing the benefits of SSRF with AD or major thoracic pathologies. Further research into the benefits of SSRF in specific thoracic pathologies may lead to improved patient outcomes. This may require the creation of profiles of patient cohorts with relevant clinical history to determine if SSRF may benefit patients with specific thoracic pathologies.

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The beneficial application of preoperative 3D printing for surgical stabilization of rib fractures

Cited by 20 publications

References 14 publications

Application of 3D printing and framework internal fixation technology for high complex rib fractures

Application of 3D printing and framework internal fixation technology for high complex rib fractures

A Review on 3D-Printed Templates for Precontouring Fixation Plates in Orthopedic Surgery

Surgical Stabilisation of Traumatic Rib Fractures with Chronic, Residual Type A Aortic Dissection

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