Baburaj Vishnu, Patel Sandeep, Kumar Vishal, Sharma Siddhartha, Dhillon Mandeep Singh
Department of Orthopedics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Clin Shoulder Elb. 2024 Mar;27(1):72-78. doi: 10.5397/cise.2023.00591. Epub 2024 Feb 8.
Clinical outcomes after fixation of distal humerus intraarticular fractures are directly related to the quality of reduction. The use of three-dimensional (3D)-printed fracture models can benefit preoperative planning to ensure good reduction. This review aims to determine if surgery performed with 3D printing assistance are faster and result in fewer complications and improved clinical outcomes than conventional methods. We also outline the benefits and drawbacks of this novel technique in surgical management of distal humerus fractures.
A systematic literature search was carried out in various electronic databases. Search results were screened based on title and abstract. Data from eligible studies were extracted into spreadsheets. Meta-analysis was performed using appropriate computer software.
Three randomized controlled trials with 144 cases were included in the final analysis. The 3D-printed group had significantly shorter mean operating time (mean difference, 16.25 minutes; 95% confidence interval [CI], 12.74-19.76 minutes; P<0.001) and mean intraoperative blood loss (30.40 mL; 95% CI, 10.45-60.36 mL; P=0.005) compared with the conventional group. The 3D-printed group also tended to have fewer complications and a better likelihood of good or excellent outcomes as per the Mayo elbow performance score, but this did not reach statistical significance.
Three-dimensional-printing-assisted surgery in distal humerus fractures has several benefits in reduced operating time and lower blood loss, indirectly decreasing other complications such as infection and anemia-related issues. Future good-quality studies are required to conclusively demonstrate the benefits of 3D printing in improving clinical outcomes. Level of evidence: I.
肱骨远端关节内骨折固定后的临床结果与复位质量直接相关。使用三维（3D）打印骨折模型有助于术前规划，以确保良好的复位。本综述旨在确定与传统方法相比，3D打印辅助手术是否更快，并发症更少，临床结果更好。我们还概述了这种新技术在肱骨远端骨折手术管理中的利弊。
在各种电子数据库中进行系统的文献检索。根据标题和摘要筛选检索结果。将符合条件的研究数据提取到电子表格中。使用适当的计算机软件进行荟萃分析。
最终分析纳入了3项随机对照试验，共144例患者。与传统组相比，3D打印组的平均手术时间显著缩短（平均差异为16.25分钟；95%置信区间[CI]为12.74 - 19.76分钟；P<0.001），平均术中出血量也显著减少（30.40 mL；95%CI为10.45 - 60.36 mL；P = 0.005）。根据梅奥肘关节功能评分，3D打印组的并发症也往往较少，获得良好或优异结果的可能性更高，但这未达到统计学意义。
3D打印辅助手术治疗肱骨远端骨折在缩短手术时间和减少出血量方面有诸多益处，间接减少了感染和贫血相关问题等其他并发症。未来需要高质量的研究来确凿证明3D打印在改善临床结果方面的益处。证据级别：I级。
