Application of 3D printing technology in the repair of pelvic fracture / 中国组织工程研究

ABSTRACT

BACKGROUND:3D printing technology for preoperative planning has been a trend at present. Moreover, this technology has been extensively used in bone tumor resection and maxilofacial surgery, but seldom used in fracture repair. OBJECTIVE: To explore the value of 3D printing technology application in preoperative evaluation of pelvic fracture, planning and during surgery. METHODS:Pelvic fracture patients underwent preoperative CT scan. Pelvic models of the patients were printed using 3D printing technology at 11. Preoperative processing was conducted, including choice of approach, design of incision exposure range, design of fracture reduction, pre-implantation position of the steel plate, optimal plastic design of steel plate, measurement of screw length and design of screw direction. Matta score of pelvic fracture reduction and Majeed score of pelvic function after repair were measured during folow-up. RESULTS AND CONCLUSION:The operation time was 55-130 minutes, averagely (84.75±20.15) minutes. Intraoperative blood loss was 200-800 mL, averagely (417.00±173.58) mL. After operation, no incision infection, fracture nonunion, fixator loosening or breakage appeared. Al patients were folowed up for 8-24 months. The fracture healing time was 10-16 weeks, averagely 12.5 weeks. Fracture reduction was assessed according to Matta scoring excelent in 15 cases, good in 3 cases, average in 2 cases, and poor in 0 case, with an excelent and good rate of 90%. Postoperative function was assessed according to Majeed scoring excelent in 13 cases, good in 5 cases, average in 2 cases, and poor in 0 case, with an excelent and good rate of 90%. These findings showed that the application of 3D printing technology in pelvic fracture can determine the fracture’s displacement, is helpful for accurate reduction and plate modeling, reduces surgery duration and intraoperative blood loss and complication, finaly achieves better surgical result. 3D printing technology can better evaluate and plan the pelvic fracture before repair, and can be used as a routine project preparation of pelvic fracture repair.