Application of 3D printing technology in treatment of displaced acetabular fractures complicated with posterior pelvic ring injury / 中华创伤骨科杂志

ABSTRACT

Objective To evaluate the application of 3D printing technology in the treatment of displaced acetabular fractures ( DAF ) complicated with unstable injury to the posterior pelvic ring. Meth-ods A retrospective study was conducted of all the 19 DAF patients complicated with unstable posterior pelvic ring who had been treated from August 2009 to June 2015 in our hospital. They were 12 men and 7 women, aged from 24 to 62 years ( average, 39. 8 years ) . Twelve DAFs were complicated with ipsilateral unstable injury to the posterior pelvic ring, 5 with contralateral unstable injury to the posterior pelvic ring, and 2 with bilateral unstable injury to the posterior pelvic ring. Preoperatively, 3D digital models of the pelvis were reconstructed for the 19 patients using their CT scanning data. Their pelvic models were printed using 3 D printing technology for visual evaluation of their fractures and design of individualized surgical proce-dures. Results With the help of their 3D printing models, the 19 patients obtained successful operations within a mean time of 3. 2 hours. Their intraoperative blood loss averaged 658. 5 mL. They were followed up for an average of 10. 7 months ( range, from 8 to 24 months ) . According to Matta′s criteria for pelvic reduc-tion, 14 cases achieved anatomical reduction, 2 satisfactory reduction and 3 unsatisfactory reduction. Ac-cording to Mears's criteria for reduction of the posterior pelvic ring, 13 cases achieved anatomical reduction, 4 satisfactory reduction and 2 unsatisfactory reduction. The 19 acetabular fractures healed after 9 to 18 weeks ( average, 14. 5 weeks ) . The pelvic fractures healed after 8 to 17 weeks ( average, 13. 5 weeks ) . According to the Merle d'Aubigne-Postel criteria at the last follow-ups, the hip functions were excellent in 7, good in 9, fair in one, and poor in 2 cases. According to the Majeed's functional evaluation, the pelvic functions were excellent in 10 cases, good in 7, fair in one, and poor in one. Complications were incision infection in one, heterotopic ossi-fication in 2, avascular necrosis of the femoral head in one and traumatic arthritis in one. Conclusion In thetreatment of DAF complicated with unstable injury to the posterior pelvic ring, application of 3D printing technology can provide direct visualization of the pelvic and acetabular fractures which facilitate preoperative evaluation and design of individualized surgical protocols, leading to fine outcomes.