Key techniques of internal fixation for proximal tibial fractures based on digital design and three-dimensional printing / 中国组织工程研究

ABSTRACT

BACKGROUND:Preliminary experiments have performed three-dimensional (3D) reconstruction of proximal tibial fractures, digital steel plate design, the establishmentof the proximal tibia plate standard parts library and the operation simulation of 3D printing. OBJECTIVE:To explore feasibility and accuracy of standard parts library plates and screws in the proximal tibial fracture internal fixation navigation in digital design combined with 3D printing model on the basis of preliminary studies. METHODS:Dicom format images of continuous thin layer CT scanning were colected in 20 cases of proximal tibial fractures, and uploaded in Mimics software for 3D reconstruction and fracture reduction. Plate and screw selected from standard part library wereusedfor virtual fixation. Navigation module with screw channel was designed. 3D printing skeleton, bone plate, and navigation module were used for skeleton model and internal fixation. Screw and plate were placed by navigation. Navigation module card, nail and board position were observed. Postoperative appearance and CT scanning were utilized to assess outcomes. RESULTS AND CONCLUSION:After CT scanning and reconstructionin 20 skeleton models, in combination with appearance, the position of plate, screw insertion point, the direction, length and diameter of the screw were consistent with that in Mimics software. The navigation module and the corresponding proximal end of the tibia were closely bonded with good fitting degree. In the application, card slots and stability were good, and could perfectly guide plate and screw placement. These reuslts suggest that with the aid of navigation module, standard parts library plate internal fixation for proximal tibia fracture has high accuracy. On the basis of digital design and 3D printing, digital internal fixation technology of standard parts library plate is expected to achieve good implant navigation in the department of orthopedics.