Comparative study of sacroiliac screw placement guided by three-dimensional printing template technology or X-ray fluoroscopy / 中华创伤杂志

ABSTRACT

Objective To compare the clinical effect of three-dimensional printing template technology with X-ray fluoroscopy in assisting surgery for sacroiliac screw placement. Methods A retrospective case-control study was conducted on 28 cases of sacroiliac complex injury from January 2015 to December 2016. The patients were divided into template group (13 cases) and fluoroscopy group (15 cases) according to whether the preoperative three-dimensional printing template was adopted. In template group, there were nine males and four females, with an average age of 46.7 years (range, 18-68 years). According to Tile typing, there were eight cases of type B (two type B1, three type B2, and three type B3) and five cases of type C (three type CI and two type C2). In fluoroscopy group, there were 11 males and four females, with an average age of 47.1 years (range, 18-65 years). According to Tile typing, there were 10 cases of type B (three type B1, four type B2, and three type B3) and five cases of type C (three type C 1 and two type C2). The screw numbers, time for single screw placement, and fluoroscopy frequency were recorded. The Matta criteria was used to evaluate fracture reduction quality, and Majeed score was used to evaluate pelvic fracture function at the last follow-up. Results All patients were followed up for 6-20 months [(10.4±0.6) months]. Fifteen screws were implanted in template group, and 17 in fluoroscopy group. The time for single screw placement was 25-38 minutes [(28 ±5.3) minutes] in template group and 45-70 minutes [(60.3 ±5.8) minutes] in fluoroscopy group (P ＜0.01). The fluoroscopy frequency was 2-5 times [(2.8 ±0.5) times] in template group and 11-23 times [(15.4 ±3.5) times] in fluoroscopy group. According to the Matta criteria, there were eight excellent cases, four good, one fair, with an excellent and good rate of 92％ in template group; there were seven excellent cases, six good, two fair, with an excellent and good rate of 87％ in fluoroscopy group (P＞0.05). According to Majeed score at the last follow up, there were eight excellent cases, three good, two fair, with an excellent and good rate of 85％ in template group; there were six excellent cases, six good, three fair, with an excellent and good rate of 80％ in fluoroscopy group (P＞0.05). Conclusions Compared with traditional surgery, three-dimensional printing template technology assisted surgery for sacroiliac screws placement presents advantages of less operation time and reduced fluoroscopy frequency. This technology improves the safety profile and should be further promoted in clinical applications.