Department of Orthopedics and Traumatology, Honghui Hospital, Xi'an JiaoTong University Health Science Center, No. 555, East Friendship Road, Xi'an, Shaanxi, China.
Department of Orthopedic Surgery, University of California, San Francisco, CA, USA.
Arch Orthop Trauma Surg. 2021 Feb;141(2):215-222. doi: 10.1007/s00402-020-03472-w. Epub 2020 May 26.
This study aimed to compare the efficacy and safety of the new method including 3D printing-based preoperative planning, surgical workshop, and contouring of the plate versus conventional method in the surgical treatment of complex acetabular fractures.
We retrospectively analyzed the data in a cohort of 88 patients of complex acetabular fracture with mean 29.95 ± 4.84 months (24-41 months) follow-up. Patients were divided into two groups. Group 1 consisting of 41 patients were performed previewed surgery with a 3D printing-based pre-contoured plate on a 3D printing model. Group 2, comprised of 47 patients, were treated by the traditional contoured plate technique. The quality of reduction was assessed using criteria described by Matta. Functional outcome was evaluated using Modified Postel Merle D'Aubigne score. A custom-made quiz was used to evaluate the chief assistant.
The study showed no significant differences in measured preoperative variables except for the age between the Group 1 and Group 2 (p > 0.05). Compared with the Group 2, the intraoperative blood loss, operative time was significantly decreased in Group 1 (p < 0.05). There were no significant statistical differences in the quality of reduction and Modified Postel Merle D'Aubigne score (p > 0.05). The result of evaluation of assistant in Group 1 was significantly high than in Group 2 (p < 0.05).
3D printing-based pre-contoured plate is a more effective and reliable method than traditional contoured plate technique for treating the complex acetabular fractures. Meanwhile, the 3D printing is a useful orthopedic surgical education tool which can improve the understanding of the complex acetabular fracture for a young surgeon.
本研究旨在比较包括基于 3D 打印的术前规划、手术车间和钢板塑形在内的新方法与传统方法治疗复杂髋臼骨折的疗效和安全性。
我们回顾性分析了 88 例复杂髋臼骨折患者的队列数据，平均随访 29.95±4.84 个月（24-41 个月）。患者分为两组。第 1 组 41 例患者在 3D 打印模型上进行了基于预成型 3D 打印板的预演手术。第 2 组 47 例患者采用传统塑形钢板技术治疗。采用 Matta 描述的标准评估复位质量。采用改良 Postel Merle D'Aubigne 评分评估功能结果。使用定制的测验评估首席助手。
研究显示，两组间除年龄外，术前测量变量无显著差异（p>0.05）。与第 2 组相比，第 1 组术中出血量和手术时间显著减少（p<0.05）。两组复位质量和改良 Postel Merle D'Aubigne 评分无显著统计学差异（p>0.05）。第 1 组的助手评估结果明显高于第 2 组（p<0.05）。
与传统塑形钢板技术相比，基于 3D 打印的预成型钢板是治疗复杂髋臼骨折的更有效、更可靠的方法。同时，3D 打印是一种有用的骨科手术教育工具，可以提高年轻医生对复杂髋臼骨折的理解。
