Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China.
Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
Postgrad Med J. 2019 Aug;95(1126):414-419. doi: 10.1136/postgradmedj-2019-136482. Epub 2019 Jul 19.
Recent years have witnessed a rapid development of three-dimensional (3D) printing technology applied in orthopaedic surgery. To be assisted by 3D printing is a potent method to realise accurate and individualised operation. The objective of this meta-analysis was to assess the efficacy of 3D printing technology in the management of trauma fractures.
PubMed, Embase and the Cochrane Library were systematically searched up until January 2019 to identify relevant studies. All clinical studies comparing conventional surgery and 3D printing-assisted surgery in the management of orthopaedic trauma were obtained. The meta-analysis was performed with RevMan V.5.3 software.
Four randomised controlled trials, four retrospective comparative studies and two prospective comparative studies involving 521 patients were included. Compared with conventional surgery, 3D printing-assisted surgery leads to shorter operation duration (mean difference (MD) -16.59 (95% CI -18.60 to -14.58), p<0.001), less intraoperative blood loss (standardised mean difference (SMD) -1.02 (95% CI -1.25 to -0.79), p<0.001) and fewer intraoperative fluroscopies (SMD -2.20 (95% CI -2.50 to -1.90), p<0.001). However, 3D printing-assisted surgery leads to longer hospital stay (MD 2.51 (95% CI 0.31 to -4.72), p=0.03). No significant results were found regarding fracture healing time, the rate of excellent and good outcomes, anatomical reduction and complications.
These results suggest that 3D printing-assisted surgery outperforms conventional surgery in the management of orthopaedic trauma fractures with shorter operation duration, less intraoperative blood loss and fewer intraoperative fluoroscopies.
近年来，三维（3D）打印技术在骨科手术中的应用发展迅速。借助 3D 打印是实现精确和个体化手术的有力方法。本荟萃分析的目的是评估 3D 打印技术在创伤骨折管理中的疗效。
系统检索了 PubMed、Embase 和 Cochrane Library，以确定截至 2019 年 1 月的相关研究。所有比较传统手术和 3D 打印辅助手术治疗骨科创伤的临床研究均被纳入。使用 RevMan V.5.3 软件进行荟萃分析。
共纳入 4 项随机对照试验、4 项回顾性对照研究和 2 项前瞻性对照研究，共 521 例患者。与传统手术相比，3D 打印辅助手术可缩短手术时间（均数差（MD）-16.59，95%可信区间（CI）-18.60 至-14.58，p<0.001）、减少术中出血量（标准化均数差（SMD）-1.02，95%CI-1.25 至-0.79，p<0.001）和减少术中透视次数（SMD-2.20，95%CI-2.50 至-1.90，p<0.001）。然而，3D 打印辅助手术可导致住院时间延长（MD 2.51，95%CI 0.31 至-4.72，p=0.03）。在骨折愈合时间、优良率、解剖复位率和并发症发生率方面，两组间无显著差异。
这些结果表明，3D 打印辅助手术在治疗骨科创伤骨折方面优于传统手术，具有手术时间更短、术中失血量更少和术中透视次数更少的优点。
