Application of rapid prototype and 3D printing in therapy of complex pilon fractures / 中华创伤骨科杂志

ABSTRACT

Objective To investigate the value of 3D rapid prototype technology in therapy of complex pilon fractures.Methods In this study,60 patients with pilon fracture who had been hospitalized during January 2013 to May 2014 were randomly and equally divided into a 3D group and a control group according to their hospitalization order.The 3D group21 males and 9 females,an average age of 34.8 ±6.0 years,13 cases of AO type C2 and 17 ones of AO type C3.The control group21 males and 9 females,an average age of 35.8 ±6.2 years,12 cases of AO type C2 and 18 ones of AO type C3.The 3D group received surgery aided by rapid prototype and 3D printing while the control group underwent conventional surgery with open reduction and internal fixation.In the 3D group,the distal tibia models were manufactured by 3D rapid prototyping technology based on the 3D reconstructions which were accomplished by computer aided technology.The diagnosis,classification and preoperative plan were then conducted using the models.The 2 groups were compared in terms of operation time,postoperative skin necrosis and infection,and Maryland foot function scoring at the last follow-up.The 2 groups were compatible in preoperative demographic data (P ＞ 0.05).Results There were significant differences between the 3D and control groups in operation time (65.1 ±4.8 minutes versus 80.5 ± 3.6 minutes) and rate of postoperative complications [6.7％ (2/30) versus 16.7％ (5/30)] (P ＜0.05).There was no significant difference between the 2 groups in the excellent to good rate by Maryland foot function scoring at the last follow-up [76.7％ (23/30) versus 73.3％ (22/30)] (P ＞ 0.05).Conclusion Since rapid prototype and 3D printing technology can display the morphology of pilon fracture intuitively and stereoscopically,it helps surgeons with accurate assessment of the fracture.3D printed models of the pilon fracture pre-operatively raise the accuracy of reduction,reduce both operation time and incision complications,and facilitate functional recovery.