Application of 3-dimension printed guide plate technology in sacroiliac screw fixation / 中华骨科杂志

ABSTRACT

Objective To investigate the application of 3-dimension printed guide plate technology in sacroiliac screw fixation.Methods A study of 5 cases (from June 2016 to December 2016) applying the 3-dimension printed guide plate technology in sacroiliac screw fixation for the treatment of posterior ring injury of pelvis was performed.There were 4 male and 1 female,aged from 42 to 67 years (average,52.4 years),4 combined with sacral fracture (3 cases of Denis Ⅰ and 1 case of Denis Ⅱ combined with nerve injury),and 1case of sacroiliac joint separation.Patients' pre-operative CT scanning data were collected and introduced to the computer system to reconstruct and print a 3-dimensional pelvic model.The working tunnel for sacroiliac screw insertion was imitated by the system and a guiding template was designed and printed on the basis of that.The analysis of each screw placement time,the exposure of X ray and bleeding volume were undertook,and the Matta radiological criteria was used to evaluate the reduction quality.The visual analogue scale (VAS) was applied to evaluate the preoperative,1week and 6-monthspostoperative coccydynia.Results 5 sacroiliac screws were inserted in 5 patients.The time for each screw placement ranged from 8 to 16 min,average 11.2 min,and the times for each screw implantation exposed to X-ray ranged from 4 to 8,average 5.6.According to Matta radiological criteria,the fracture reduction was excellent in 4 cases and good in 1,giving an excellent to good rate of 100％.The volume of intraoperative bleeding was 20 to 50 ml,mean 30±0.7 ml.The average preoperative VAS score was 5.2 to 8.1,mean 7.04±0.1.The average VAS score was 5.46±0.3 at 1-week of postoperation;1.48±0.2 at 6-month after operation.The pain level decreased significantly from moderate/severe (preoperative) to slight (6-month postoperative).Postoperative Majeed score was 86 to 92,mean 90±0.5,giving a good-excellent rate 100％.Conclusion The 3-dimension printed guide plate technology,with the advantages of minimal invasive,less exposure to X-ray and a definite curative effect,can significantly simplify the procedure of the placement of sacroiliac screws in fixation of posterior ring injury of pelvis.