Department of Trauma and Orthopaedics, Tallaght University Hospital, Dublin, 24, Ireland.
Ir J Med Sci. 2020 Feb;189(1):219-228. doi: 10.1007/s11845-019-02055-y. Epub 2019 Jul 6.
Complex pelvic fractures present the orthopaedic surgeon with many challenges. 3-D printed models may provide assistance in pre-operative planning, may lead to improvements in intra-operative (i) decision making and (ii) efficiencies (time reduction, blood loss reduction, screening reduction) and may result in improvements in post-operative outcomes (fracture reduction & quality of life). The models also provide hands-on opportunities for orthopaedic trainees and patients. This may result in improvements in (i) education/training regarding the management of pelvic and acetabular fractures for orthopaedic trainees and (ii) improvements in patient consenting and overall patient satisfaction.
Single-centre, two orthopaedic surgeons (pelvic and acetabular fellowship trained), prospective observational study. Twenty patients with acute displaced pelvic/acetabular fracture(s); ten 3-D-printed pelvis and ten non-printed cases for comparison. The comparison cohorts were matched for fracture classification, sex and age.
Classification assistance, intra-operative time, estimated blood loss, screening amount, post-operative reduction and infection, EQ-5D-5L, teaching/educational assistance and pre-operative counselling.
The models provided more information regarding fracture pattern, however, this did not result in change of CT-planned approach/procedure or patient outcomes. The models scored highly on surgeon's questionnaire. The models were found to have a positive impact on trainee education and patient consenting/counselling. With regard to objective comparisons, there was no significant improvements in time-to-surgery, intra-operative time, estimated blood loss, screening amount, fracture reduction or infection rate. There was no significant difference in quality of life questionnaire ~ 12 months post-surgery (statistical tests used; Cohen's effect size and Fisher's exact test).
Whilst the authors recognize the positive subjective findings with respect to the use of 3-D printing in pelvic and acetabular trauma in our National Centre, objective findings were lacking.
复杂骨盆骨折给骨科医生带来了许多挑战。3D 打印模型可以帮助术前规划，可能会提高术中（i）决策制定和（ii）效率（缩短时间、减少失血、减少筛查），并可能改善术后结果（骨折复位和生活质量）。模型还为骨科受训者和患者提供了实践机会。这可能会提高（i）骨科医生管理骨盆和髋臼骨折的教育/培训水平，以及（ii）患者同意和整体患者满意度。
单中心、两位骨科医生（骨盆和髋臼 fellowship培训）、前瞻性观察研究。20 例急性移位骨盆/髋臼骨折患者；10 例 3D 打印骨盆和 10 例非打印骨盆进行比较。比较队列在骨折分类、性别和年龄方面相匹配。
分类辅助、手术时间、估计失血量、筛查量、术后复位和感染、EQ-5D-5L、教学/教育辅助和术前咨询。
模型提供了更多关于骨折模式的信息，但这并没有改变 CT 计划的手术方法/程序或患者的结果。模型在外科医生的问卷中得分很高。模型被发现对学员教育和患者同意/咨询有积极影响。在客观比较方面，手术时间、术中时间、估计失血量、筛查量、骨折复位或感染率没有显著改善。术后 12 个月生活质量问卷无显著差异（使用的统计检验；Cohen 的效应大小和 Fisher 精确检验）。
尽管作者承认在我们的国家中心使用 3D 打印治疗骨盆和髋臼创伤的积极主观发现，但客观发现缺乏。
