Three-dimensional printing of patient-specific plates for the treatment of acetabular fractures involving quadrilateral plate disruption

Abstract

Background: Complicated acetabular fractures comprise the most challenging field for orthopedists. The purpose of this study was to develop three-dimensional printed patient-specific (3DPPS) Ti-6Al-4 V plates to treat complicated acetabular fractures involving quadrilateral plate (QLP) disruption and to evaluate their efficacy. Methods: Fifty patients with acetabular fractures involving QLP disruption were selected between January 2016 and June 2017. Patients were divided into a control group (Group A, 35 patients) and an experimental group (Group B, 15 patients), and were treated by the conventional method of shaping reconstruction plates or with 3DPPS Ti-6AL-4 V plates, respectively. The efficacy of Ti-6AL-4 V plates was evaluated by blood loss, operative time, reduction quality, postoperative residual displacement, and complications. Results: The operative time and blood loss in Group B were reduced compared to Group A, and the difference was statistically significant (P < 0.05). There was no significant difference in reduction quality between the two groups (P > 0.05). Reduction quality in Group B was anatomic in 10 (66.7%), satisfactory in four (26.7%), and poor in one (6.7%). In Group A, they were anatomic in 18 (51.4%), satisfactory in 13 (37.1%), and poor in four (11.4%). Residual displacement in Group B was less than that in Group A, and the difference was statistically significant (P < 0.05). In Group B, one case exhibited loosening of the pubic screw postoperatively. In Group A, there was one case of wound infection, one of deep vein thrombosis (DVT) in the ipsilateral lower limb, one case of traumatic arthritis and two obturator nerve injuries.

Patient-specific plate for navigation and fixation of the distal radius: a case series

“…These reported residual errors are comparable with those we found in our study (TTE = 3.1 mm, TRE = 8.3°). Titanium PSPs have been 3D printed for a multitude of clinical applications, including reconstructive surgery of the skull [34], orbital floor [35], mandibula [36], maxilla [37], sternum [38], acetabulum [39], radius and ulna shaft [25], and distal radius [16,24,25]. Comparing the positioning results in applicable studies is often difficult since different evaluation parameters and dimensions are used to quantify the residual positioning error.…”

Open reduction and internal fixation of quadrilateral plate fractures in the elderly: association between initial fracture pattern and outcomes

“…And design the optimal reduction sequence and further provide a reference for the selection and measurement of the plate. Many scholars have advocated the application of virtual and 3D printing technology in the treatment of pelvic and acetabular fracture [ 26 , 27 ]. However, it should be noted that the basis of computer assisted surgery is the 3D model of acetabular fracture, either through virtual technology or 1:1 printed 3D fracture model.…”

Does 3D-Assisted Acetabular Fracture Surgery Improve Surgical Outcome and Physical Functioning?—A Systematic Review

“…Three randomised controlled trials [38,43,44], one prospective cohort study [40], ten case control studies [30][31][32]34,35,41,42,[45][46][47], and five case series [29,33,36,37] were included. The methodological quality of the papers varied from low (Table 3) to good (Table 4).…”

“…Nine of these full-text articles were excluded due to the following reasons: foreign language article on 3D printing and pre-contouring the implant (N = 1); case reports (N = 2); descriptive study (N = 1); biomechanical study (N = 1); conference abstract (N = 1); outcome measurements unclear (N = 3). In total, 19 studies met the inclusion criteria for this systematic review (Figure 1) [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. The included studies enrolled a total of 753 patients (median sample size 27; range 10-146).…”