Pre-operative virtual simulation and three-dimensional printing techniques for the surgical management of acetabular fractures
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Surgical treatment of acetabular fractures with plate fixation is challenging for orthopaedic surgeons because of variations of the surface curvature and complex fracture patterns of the acetabulum. We present our experience with pre-operative computer-assisted virtual simulation and three-dimensional (3D) printing techniques for the surgical treatment of acetabular fractures, especially in terms of operative time and surgical outcomes.
Twenty-nine patients with acetabular fractures treated with locking plates were included in this retrospective study (conventional locking plate fixation, n = 17; 3D-printing-assisted precontoured locking plate fixation, n = 12). Fracture types were classified according to the Letournel-Judet classification. Surgical duration, instrumentation time, blood loss, post-operative fracture reduction quality, and complication rates were compared between the two surgical groups.
The 3D-printing group had a significantly shorter total surgical duration and instrumentation time for fractures with posterior wall or posterior column involvement (222.75 ± 48.12 and 35.75 ± 9.21 minutes, respectively; P < 0.05) and significantly shorter instrumentation time and less blood loss for fractures with anterior column involvement (43.40 ± 10.92 minutes and 433.33 ± 317.28 mL, respectively; P < 0.05) than those in the control group. The post-operative radiological results (assessed by consensus) were similar for both groups (good/fair: 14/3 vs. 11/1; P = 0.622). The complication rate was lower in the 3D-printing group than in the conventional group (16.67 vs. 29.41%).
The 3D printing is a reliable method for treating acetabular fractures, and can reduce the surgical duration, instrumentation time, and blood loss.
KeywordsAcetabulum fracture Pre-operative virtual simulation Three-dimensional (3D) printing Precontoured
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflicts of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of our Institutional Review Board and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 13.Boudissa M, Ruatti S, Kerschbaumer G, Milaire M, Merloz P, Tonetti J (2016) Part 2: outcome of acetabular fractures and associated prognostic factors-a ten-year retrospective study of one hundred and fifty-six operated cases with open reduction and internal fixation. Int Orthop 40:2151–2156CrossRefGoogle Scholar
- 20.Guimarães JAM, Martin MP 3rd, da Silva FR, Duarte MEL, Cavalcanti ADS, Machado JAP, Mauffrey C, Rojas D (2018) The obturator oblique and iliac oblique/outlet views predict most accurately the adequate position of an anterior column acetabular screw. Int Orthop. https://doi.org/10.1007/s00264-018-3989-5