Capital Veterinary Specialists, Jacksonville, Florida, United States.
MedVet Akron, Akron, Ohio, United States.
Vet Comp Orthop Traumatol. 2021 Jan;34(1):1-8. doi: 10.1055/s-0040-1719169. Epub 2020 Nov 25.
The aim of this study was to evaluate the accuracy of patient-specific three-dimensional printed drill guides (3D-PDG) for the placement of a coxofemoral toggle via a minimally invasive approach.
Pre-procedure computed tomography (CT) data of 19 canine cadaveric hips were used to design a cadaver-specific 3D-PDG that conformed to the proximal femur. Femoral and acetabular bone tunnels were drilled through the 3D-PDG, and a coxofemoral toggle pin was placed. The accuracy of tunnel placement was evaluated with post-procedure CT and gross dissection.
Coxofemoral toggle pins were successfully placed in all dogs. Mean exit point translation at the fovea capitis was 2.5 mm (0.2-7.5) when comparing pre- and post-procedure CT scans. Gross dissection revealed the bone tunnel exited the fovea capitis inside (3/19), partially inside (12/19) and outside of (4/19) the ligament of the head of the femur. Placement of the bone tunnel through the acetabulum was inside (16/19), partially inside (1/19) and outside (2/19) of the acetabular fossa. Small 1 to 2 mm articular cartilage fragments were noted in 10 of 19 specimens.
Three-dimensional printed drill guide designed for coxofemoral toggle pin application is feasible. Errors are attributed to surgical execution and identification of the borders of the fovea capitis on CT data. Future studies should investigate modifications to 3D-PDG design and methods. Three-dimensional printed drill guide for coxofemoral toggle pin placement warrants consideration for use in select clinical cases of traumatic coxofemoral luxation.
本研究旨在评估经皮微创入路应用患者特异性三维打印导板（3D-PDG）放置股髋 toggle 钉的准确性。
使用 19 个犬尸体髋关节的术前计算机断层扫描（CT）数据来设计符合股骨近端的特定于尸体的 3D-PDG。通过 3D-PDG 钻取股骨和髋臼骨隧道，并放置股髋 toggle 钉。使用术后 CT 和大体解剖评估隧道放置的准确性。
所有犬均成功放置股髋 toggle 钉。比较术前和术后 CT 扫描，股骨头凹出口点的平均平移为 2.5mm（0.2-7.5）。大体解剖显示，骨隧道在股骨头凹（3/19）、股骨头凹内部分（12/19）和股骨头凹外（4/19）处穿出。髋臼骨隧道的放置位置在髋臼内（16/19）、髋臼内部分（1/19）和髋臼外（2/19）。在 19 个标本中有 10 个标本中可见 1 到 2mm 的小关节软骨碎片。
用于股髋 toggle 钉应用的三维打印导板设计是可行的。误差归因于手术执行和在 CT 数据上识别股骨头凹边界。未来的研究应探讨对 3D-PDG 设计和方法的改进。用于股髋 toggle 钉放置的三维打印导板值得考虑在创伤性股髋脱位的某些临床病例中使用。
