Efficacy of 3d printing technology-assisted virtual surgical planning in Acetabular fracture fixation / 中国组织工程研究

ABSTRACT

BACKGROUND: Acetabular fracture is considered to be one of the most challenging fractures because of its complex anatomical structure, which makes it more difficult to treat. At present, open reduction and internal fixation are still the standard treatment methods for displaced acetabular fractures. The patient-specific pre-contour reconstruction template made by three-dimensional (3D) printing technology combined with preoperative virtual surgery plan can reduce the invasiveness of surgery and simplify the operation process. OBJECTIVE: To evaluate the effect of 3D printing combined with virtual surgical planning in the treatment of acetabular fractures compared with traditional reduction and reconstruction of acetabular fractures. METHODS: Totally 25 patients were selected from Affiliated Hospital of Chengde Medical College from October 1, 2017 to March 1, 2018, including 14 males and 11 females, at the age of 21-60 years old. They were divided into experimental group (n=12) and control group (n=13) by computer random grouping method. In the experimental group, printing technology combined with virtual pre-contour reconstruction plate fixation was performed. In the control group, intraoperative contour reconstruction plate fixation was conducted after reduction. Postoperative X-ray and non-contrast CT scan was used to analyze fracture reduction in two groups. After the operation, the patients in the two groups were followed up for visual analogue scale score, Majeed function score and complications. This study was approved by the Ethics Committee of Affiliated Hospital of Chengde Medical College (approval No. LL007). RESULTS AND CONCLUSION: (1) X-ray films showed that the reduction effect of the experimental group was better than that of the control group (P=0.038). Non-contrast CT images showed that the reduction displacement difference of the experimental group was better than that of the control group before and after operation [(12.43±7.58) mm, (9.408±8.27) mm, P < 0.05]. (2) At 6-12 months after surgery, visual analogue scale scores were lower in the experimental group than in the control group [(1,6±0.6), (3.3±1.3), P < 0.05], There were no significant differences in Majeed function scores between the two groups in the final follow-up (P=0.079). (3) Complications, such as delayed healing, failure of internal fixation or deep vein thrombosis, were not found; and no biocompatibility adverse reactions related to the implanted device occurred in the two groups after surgery. (4) Results suggested that 3D printing technology assisted virtual operation plan can improve the reduction quality in the fixation of acetabular fracture, improve the operative effect of acetabular fracture, and reduce the postoperative pain of patients.