Maini Lalit, Mishra Abhishek, Agarwal Gaurang, Verma Tarun, Sharma Amit, Tyagi Amit
Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India.
J Clin Orthop Trauma. 2018 Jul-Sep;9(3):236-240. doi: 10.1016/j.jcot.2018.07.009. Epub 2018 Jul 30.
Acetabulum has a complex anatomy due to which anatomical acetabular plates are still under developmental phase. Although intra-operative contouring of reconstruction plate is done as a standard practice, it is associated with increased operative time and morbidity of patient. We have designed an acetabular plate for posterior fixation from experience of previous studies performed in our institute on acetabular fracture fixation which should be appropriate for most of the patient of Indian origin. Apart from avoiding intra-operative contouring of acetabular plates it also helps in preventing intra articular screw penetration.
We selected five consecutive patients with acetabular fracture needed to be operated from posterior approach and designed patient specific plate template from virtual surgical planning and 3D printing. These plate templates were then matched with our acetabular plate design and were used intra-operatively. Many parameters were assessed to evaluate accuracy of our plate design in those five patients.
All the plate templates appear to match our designed plate and no intra-operative contouring was required with our plate design.
This was a pilot study and we need a large sample size to study accuracy of our acetabular plate design which might avoid intra-operative contouring, decreasing morbidity of patient and prevent wastage of resources in pre-operative planning and computer designing.
髋臼解剖结构复杂,这使得解剖型髋臼钢板仍处于研发阶段。尽管术中对重建钢板进行塑形是一种标准操作,但这会增加手术时间和患者的发病率。我们根据在本研究所进行的关于髋臼骨折固定的先前研究经验,设计了一种用于后路固定的髋臼钢板,该钢板应适用于大多数印度裔患者。除了避免术中对髋臼钢板进行塑形外,它还有助于防止关节内螺钉穿透。
我们连续选择了五名需要通过后路手术治疗的髋臼骨折患者,通过虚拟手术规划和3D打印设计了患者特异性钢板模板。然后将这些钢板模板与我们的髋臼钢板设计进行匹配,并在术中使用。评估了许多参数以评估我们的钢板设计在这五名患者中的准确性。
所有钢板模板似乎都与我们设计的钢板匹配,使用我们的钢板设计无需术中塑形。
这是一项初步研究,我们需要大样本量来研究我们髋臼钢板设计的准确性,这可能避免术中塑形,降低患者发病率,并防止术前规划和计算机设计中的资源浪费。