Yang Sha, Lin Huapeng, Luo Cong
Department of Orthopaedics, Children's Hospital of Chongqing Medical University, Chongqing, China.
Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing Engineering Research Center of Stem Cell Therapy, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, China.
Front Surg. 2021 Aug 31;8:696391. doi: 10.3389/fsurg.2021.696391. eCollection 2021.
Traumatic fracture is a common orthopaedic disease, and application of 3D printing technology in fracture treatment, which entails utilisation of pre-operative printed anatomic fracture model, is increasingly gaining popularity. However, effectiveness of 3D printing-assisted surgery lacks evidence-based findings to support its application. Embase, PubMed and Cochrane Library databases were systematically searched until October, 2020 to identify relevant studies. All randomised controlled trials (RCTs) comparing efficacy of 3D printing-assisted surgery vs. conventional surgery for traumatic fractures were reviewed. RevMan V.5.3 software was used to conduct meta-analysis. A total of 12 RCTs involving 641 patients were included. Pooled findings showed that 3D printing-assisted surgery had shorter operation duration [standardised mean difference (SMD) = -1.52, 95% confidence interval (CI) - 1.70 ~ -1.34, < 0.00001], less intraoperative blood loss (SMD = 1.34, 95% CI 1.74 ~ 0.94, < 0.00001), fewer intraoperative fluoroscopies (SMD = 1.25, 95% CI 1.64 ~ 0.87, < 0.00001), shorter fracture union time (SMD = -0.15, 95% CI -0.25 ~ -0.05, = 0.003), and higher rate of excellent outcomes (OR = 2.40, 95% CI 1.07 ~ 5.37, = 0.03) compared with conventional surgery. No significant differences in complication rates were observed between the two types of surgery (OR = 0.69, 95% CI 0.69 ~ 1.42, = 0.32). Indicators including operation duration, intraoperative blood loss, number of intraoperative fluoroscopies, fracture union time, and rates of excellent outcomes showed that 3D printing-assisted surgery is a superior alternative in treatment of traumatic fractures compared with conventional surgery. Moreover, the current study did not report significant differences in incidence of complications between the two approaches. CRD42021239507.
创伤性骨折是一种常见的骨科疾病，3D打印技术在骨折治疗中的应用越来越受欢迎，该技术需要使用术前打印的解剖骨折模型。然而，3D打印辅助手术的有效性缺乏循证医学研究结果来支持其应用。我们系统检索了Embase、PubMed和Cochrane图书馆数据库，直至2020年10月，以确定相关研究。对所有比较3D打印辅助手术与传统手术治疗创伤性骨折疗效的随机对照试验（RCT）进行了综述。使用RevMan V.5.3软件进行荟萃分析。共纳入12项RCT，涉及641例患者。汇总结果显示，与传统手术相比，3D打印辅助手术的手术时间更短[标准化均数差（SMD）=-1.52，95%置信区间（CI）-1.70-1.34，P<0.00001]，术中失血量更少（SMD=-1.34，95%CI-1.74-0.94，P<0.00001），术中透视次数更少（SMD=-1.25，95%CI-1.64-0.87，P<0.00001），骨折愈合时间更短（SMD=-0.15，95%CI-0.25-0.05，P=0.003），优良率更高（OR=2.40，95%CI 1.075.37，P=0.03）。两种手术的并发症发生率无显著差异（OR=0.69，95%CI 0.691.42，P=0.32）。包括手术时间、术中失血量、术中透视次数、骨折愈合时间和优良率等指标表明，与传统手术相比。此外，本研究未报告两种手术方法在并发症发生率上的显著差异。CRD42021239507。
