Department of Orthopaedic Surgery, Tri-Service General Hospital and National Defense Medical Center, 325, Cheng-Gong Road, Section 2, Taipei, 114, Taiwan, Republic of China.
School of Public Health, National Defense Medical Center, No.161, Sec. 6, Minquan E. Rd., Neihu Dist, Taipei City, 11490, Taiwan, Republic of China.
Int Orthop. 2019 Aug;43(8):1969-1976. doi: 10.1007/s00264-018-4111-8. Epub 2018 Aug 20.
Surgical treatment of acetabular fractures with plate fixation is challenging for orthopaedic surgeons because of variations of the surface curvature and complex fracture patterns of the acetabulum. We present our experience with pre-operative computer-assisted virtual simulation and three-dimensional (3D) printing techniques for the surgical treatment of acetabular fractures, especially in terms of operative time and surgical outcomes.
Twenty-nine patients with acetabular fractures treated with locking plates were included in this retrospective study (conventional locking plate fixation, n = 17; 3D-printing-assisted precontoured locking plate fixation, n = 12). Fracture types were classified according to the Letournel-Judet classification. Surgical duration, instrumentation time, blood loss, post-operative fracture reduction quality, and complication rates were compared between the two surgical groups.
The 3D-printing group had a significantly shorter total surgical duration and instrumentation time for fractures with posterior wall or posterior column involvement (222.75 ± 48.12 and 35.75 ± 9.21 minutes, respectively; P < 0.05) and significantly shorter instrumentation time and less blood loss for fractures with anterior column involvement (43.40 ± 10.92 minutes and 433.33 ± 317.28 mL, respectively; P < 0.05) than those in the control group. The post-operative radiological results (assessed by consensus) were similar for both groups (good/fair: 14/3 vs. 11/1; P = 0.622). The complication rate was lower in the 3D-printing group than in the conventional group (16.67 vs. 29.41%).
The 3D printing is a reliable method for treating acetabular fractures, and can reduce the surgical duration, instrumentation time, and blood loss.
由于髋臼表面曲率和复杂骨折模式的变化，对于骨科医生来说，使用钢板固定治疗髋臼骨折具有挑战性。我们介绍了我们在髋臼骨折手术治疗中使用术前计算机辅助虚拟模拟和三维（3D）打印技术的经验，特别是在手术时间和手术结果方面。
本回顾性研究纳入了 29 例使用锁定钢板治疗的髋臼骨折患者（传统锁定钢板固定，n=17；3D 打印辅助预弯锁定钢板固定，n=12）。骨折类型根据 Letournel-Judet 分类进行分类。比较两组手术的手术时间、器械时间、出血量、术后骨折复位质量和并发症发生率。
3D 打印组后壁或后柱骨折的总手术时间和器械时间明显缩短（分别为 222.75±48.12 分钟和 35.75±9.21 分钟；P<0.05），前柱骨折的器械时间和出血量明显缩短（分别为 43.40±10.92 分钟和 433.33±317.28 毫升；P<0.05）。两组术后影像学结果（经共识评估）相似（良好/一般：14/3 与 11/1；P=0.622）。3D 打印组的并发症发生率低于传统组（16.67%与 29.41%）。
3D 打印是治疗髋臼骨折的可靠方法，可缩短手术时间、器械时间和出血量。
