Application of 3D printing technology on the treatment of complex proximal humeral fractures (Neer3-part and 4-part) in old people

You, Wen-ting; Liu, L.J.; Chen, H.X.; Xiong, Jun; Wang, D.M.; Huang, Jiajun; Ding, Jun; Wang, D.P.

doi:10.1016/j.otsr.2016.06.009

Cited by 71 publications

(70 citation statements)

References 9 publications

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“…The manipulation of three-dimensional models seems to facilitate the diagnosis and reproducibility using the AO/OTA and Neer Classifications, 1970 [5]. In the case of surgical treatments, preoperative planning can be carried out with 3D-models, allowing the surgeon to train strategies and maneuvers to reposition the deviated bone fragments and choose the implants for each patient before surgery [11,18,19]. The choice involves size and models of plates or nails, screws, and others.…”

Section: Discussionmentioning

confidence: 99%

Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures

et al. 2020

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Background: The agreement for the treatment of proximal humerus fractures is low. Interpretation of exams used for diagnosis can be directly associated with this limitation. This study proposes to compare the agreement between experts and residents in orthopedics for treatment indication of proximal humerus fractures, utilizing 3Dmodels, holography (augmented reality), x-rays, and tomography as diagnostic methods. Methods: Twenty orthopedists (ten experts in shoulder and elbow surgery and ten experts in traumatology) and thirty resident physicians in orthopedics evaluated nine fractures of the proximal humerus, randomly distributed as x-rays, tomography, 3D-models and holography, using the Neer and AO / OTA Classifications. After, we evaluated the interobserver agreement between treatment options (conservative, osteosynthesis and arthroplasty) and whether the experience of the evaluators interfered with the results. Results: The interobserver agreement analysis showed the following kappa-values: κ = 0.362 and κ = 0.306 for experts and residents (3D-models); κ = 0.240 and κ = 0.221 (X-ray); κ = 0.233 and κ = 0.123 (Tomography) and κ = 0.321 and κ = 0.160 (Holography), for experts and residents respectively. Moreover, residents and specialists were discordant in the treatment indication using Tomography as a diagnostic method (p = 0.003). The same was not seen for the other diagnostic methods (p > 0.05). Conclusions: Three-dimensional models showed, overall, the highest interobserver agreement (experts versus residents in orthopedics) for the choice of treatment of proximal humerus fractures compared to X-ray, Tomography, and Holography. Agreement in the choice of treatment among experts that used Tomography and Holography as diagnostic methods were two times higher compared to residents.

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Section: Discussionmentioning

confidence: 99%

Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures

et al. 2020

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“…However, how to produce a suitable helical plate for each individual patient is a big question for surgeons. Previous studies have proven that the 3D printing technique is a good tool for designing surgical plans and pre-contouring plates used to treat other bone fractures [ 18 – 20 ]. Our results demonstrate the benefit of pre-contouring plates on a 3D-printed model for this special technique.…”

Section: Discussionmentioning

confidence: 99%

Proximal third humeral shaft fractures fixed with long helical PHILOS plates in elderly patients: benefit of pre-contouring plates on a 3D-printed model—a retrospective study

Wang

Guan

et al. 2018

J Orthop Surg Res

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BackgroundTo explore the clinical efficacy of 3D printing fracture models to assist in creating pre-contoured plates to treat proximal third humeral shaft fractures.MethodsWe retrospectively identified proximal third humeral shaft fractures treated between February 2012 and February 2015. The patients were divided into two groups according to the treatment procedure: a Synbone group and a 3D-printed group. In the Synbone group, long proximal humeral internal locking system plates were pre-contoured into helical shape on Synbones before surgery, while in the 3D-printed group, they were contoured on 3D-printed bone models. The pre-contoured plates were sterilized before surgery and were then used for fracture fixation during surgery. Duration of surgeries, blood loss volumes, the incidence of complications, and the time to fracture union were recorded, and functional outcomes were assessed by the Constant-Murley shoulder score and the Mayo Elbow Performance Score (MEPS) at 1-year follow-up.ResultsThe subjects comprised 46 patients; 25 patients were allocated to the Synbone group and the remaining 21 to the 3D-printed group. There was no significant difference between the baseline characteristics of the two groups. At the 1-year follow-up visit, all fractures were healed and showed a satisfactory outcome. There were no instances of iatrogenic radial nerve injury, and there was no significant difference between the two groups with regard to fracture union time, Constant-Murley score, or MEPS score. Surgery duration was significantly shorter in the 3D-printed group compared to the Synbone group (42.62 vs. 60.36 min, P = 0.001), and the 3D-printed group lost less blood during surgery (105.19 vs. 120.80 ml, P = 0.001). In addition, in the 3D-printed group, 9 surgeries were finished by senior attending doctors and 12 were finished by junior attending doctors; however, there was no significant difference between the 1-year outcomes of the two grades of surgeons.ConclusionsOur results show that the 3D printing technique is helpful in shortening the duration of surgery, reducing blood loss volume, and in making this surgical procedure easier for less-experienced surgeons.Trial registrationThis clinical study was registered in CHICTR on September 30, 2017 (number 17012852).

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“…The typical medical applications of 3D printing include preoperative planning and simulation, sharing detailed surgical information before surgery with patients, and the development of individualized implants and prostheses. 9,10 Unquestionably, 3D printing represents a major opportunity for regenerative medicine 11 and has been applied in attempts to address the demand for tissue engineered scaffolds, artificial tissues, and even organs suitable for transplantation. 5 3D printing is a broad concept that can be classified as additive manufacturing.…”

Section: Introductionmentioning

confidence: 99%

Nano-biphasic calcium phosphate/polyvinyl alcohol composites with enhanced bioactivity for bone repair via low-temperature three-dimensional printing and loading with platelet-rich fibrin

Song

Lin

et al. 2018

IJN

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Background and aim As a newly emerging three-dimensional (3D) printing technology, low-temperature robocasting can be used to fabricate geometrically complex ceramic scaffolds at low temperatures. Here, we aimed to fabricate 3D printed ceramic scaffolds composed of nano-biphasic calcium phosphate (BCP), polyvinyl alcohol (PVA), and platelet-rich fibrin (PRF) at a low temperature without the addition of toxic chemicals. Methods Corresponding nonprinted scaffolds were prepared using a freeze-drying method. Compared with the nonprinted scaffolds, the printed scaffolds had specific shapes and well-connected internal structures. Results The incorporation of PRF enabled both the sustained release of bioactive factors from the scaffolds and improved biocompatibility and biological activity toward bone marrow-derived mesenchymal stem cells (BMSCs) in vitro. Additionally, the printed BCP/PVA/PRF scaffolds promoted significantly better BMSC adhesion, proliferation, and osteogenic differentiation in vitro than the printed BCP/PVA scaffolds. In vivo, the printed BCP/PVA/PRF scaffolds induced a greater extent of appropriate bone formation than the printed BCP/PVA scaffolds and nonprinted scaffolds in a critical-size segmental bone defect model in rabbits. Conclusion These experiments indicate that low-temperature robocasting could potentially be used to fabricate 3D printed BCP/PVA/PRF scaffolds with desired shapes and internal structures and incorporated bioactive factors to enhance the repair of segmental bone defects.

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Application of 3D printing technology on the treatment of complex proximal humeral fractures (Neer3-part and 4-part) in old people

Cited by 71 publications

References 9 publications

Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures

Three-dimensional models increase the interobserver agreement for the treatment of proximal humerus fractures

Proximal third humeral shaft fractures fixed with long helical PHILOS plates in elderly patients: benefit of pre-contouring plates on a 3D-printed model—a retrospective study

Nano-biphasic calcium phosphate/polyvinyl alcohol composites with enhanced bioactivity for bone repair via low-temperature three-dimensional printing and loading with platelet-rich fibrin

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