Short-term results and complications of the operative treatment of the distal radius fracture AO2R3 C type, planned by using 3D-printed models. Prospective randomized control study.

PURPOSE: 3D-printed models rapidly evolving in orthopaedic. Studies show that 3D-printed models used for preoperative planning improve a better understanding of fracture morphology and reduce operative time, blood loss and frequency of fluoroscopy, but there are no studies that investigated possible advantages in the outcomes and complications for the treatment of distal radius fracture (DRF). Our study aims to evaluate short-term functional results and complications between two groups treated DRF using 3D-printed models for preoperative planning and without. We hypothesize that the addition of 3D-printed models would improve functional outcomes and reduce complication rates. METHODS: 66 randomized cases of DRF AO/OTA C type were enrolled and divided into "Control group" (n = 33) and "3D-printed model group" (n = 33). Personalized 3D-printed models were created. The primary outcomes were: Patient-Rated Wrist Evaluation questionnaire, Quick Disabilities of the Arm, Shoulder and Hand Score questionnaire, and complications. The secondary outcomes were: measurement of the range of motions, grip strength, radiological evaluation, and the visual analogue scale. Assessments were measured at 6 weeks, 3 months, and 6 months intervals. RESULTS: We found that the integration of the 3D-printed model in preoperative planning decreased complication incidence significantly - from 30.3% in the "Control group" to 6.1% in the "3D-printed model group", p = .022. But we did not find a difference in functional and radiological outcomes. CONCLUSION: The 3D-printed models for preoperative planning surgically treating DRF AO/OTA C type can help minimize the complication rate, however, they can't improve functional outcomes in the short-term results. LEVEL OF EVIDENCE: Level I randomized controlled study.

The role of 3-dimensional printed models in the management of the distal radius fractures.

OBJECTIVE: This study aimed to compare inter- and intra-observer agreement between radiographs with 2-dimensional and 3-dimensional computed tomography scans with and without 3-dimensional printed models in the evaluation of the distal radius fracture of Association for Osteo synth esis/ Ortho paedi c Trauma Association type C classification. METHODS: Fifteen consecutive cases with X-Rays, 2-dimensional and 3-dimensional computed tomography reconstructions views, and 3-dimensional printed models were selected. Three-dimensional printed models of the distal radius fractures were created using 2-dimensional computed tomography scan files in Digital Imaging and Communication in Medicine format, processed with the 3-dimensional Slicer software, and segmented, creating a 3-dimensional printed model in Standard Triangle Language format. Threedimensional models were printed using fused deposition modeling (FDM) type 3D printer Zortrax M200Plus using polylactic acid material on a scale of 1 : 1. Twenty observers were invited into the study. RESULTS: Intra- and inter-observer reliability was analyzed using Fleiss' kappa statistics. Overall kappa values for both groups in interobserver agreement range from 0.113 to 0.283 and in intra-observer agreement from 0.25 to 0.545. Generally, inter-observer agreement increased with additional 3-dimensional printed models from slight to fair, and intra-observer agreement increased from fair to moderate. Surgeons' opinions about 3-dimensional printed models with Likert scale-type questions show positive overall results ranging from 8.3± 2.1 to 8.6 ± 1.4. CONCLUSION: This study has shown that the inter- and intra-observer agreement with the addition of a 3-dimensional printed model for the evaluation of the distal radius fractures of Association For Osteo synth esis/ Ortho pedic Trauma Association C type for classification, fractures morphology, and preoperative planning tends to increase; however, improvements for an inter-observer agreement remain fair. LEVEL OF EVIDENCE: Level III Diagnostic Study.

Identification of the location of the A1 pulley combining palpation technique with palm landmarks and percutaneous release of A1 pulley with a 19-gauge needle: A cadaveric study.

The aims of this study were to identify the location of the A1 pulley combining palpation technique with superficial palm landmarks and to determine the efficacy and safety of A1 pulley percutaneous release with a 19-gauge needle. Fourteen fresh frozen cadaveric specimens were used: 56 fingers and 14 thumbs. The location of the A1 pulley was based on anatomical landmarks and was identified in all digits. Complete release of the A1 pulley occurred in 60 of the 70 digits (85.7%). The length of the A1 pulley in thumbs was 5.7 mm and in other fingers 4.5 mm. There were no signs of neurovascular bundle injuries. The mean distance between needle pathway and neurovascular bundle was 4.3 mm in the thumbs and 6.5 mm in the other fingers. There were no total flexor tendon injuries. The location of the A1 pulley can be predicted with success. Percutaneous release of the A1 pulley with a 19-gauge needle shows acceptable results in both safety and efficacy.