Do three-dimensional modeling and printing technologies have an impact on the surgical success of percutaneous transsacral screw fixation?

Abstract

Caused by high-energy traumas, pelvic injuries are life-threatening complex injuries posing several unfavorable effects on the body. Pelvic fractures account for approximately 3-4.3% of all skeletal fractures. [1,2] Mortality rates due to pelvic injuries vary from 10 to 16%. [1,3] Victims of these injuries display an increased tendency to develop complications due to the nature of the injury and modes of treatment. [4-8] Complications are critical for patient survival and sequelae development. Percutaneous iliosacral and transsacral-transiliac screw fixation are the commonly preferred surgical methods for the treatment of posterior pelvic injuries. The advantages of this technique include minimal tissue damage due to the surgical procedure, improved stability of the fixation, short surgery time, and reduced risk for wound-related problems in the postoperative period. [9,10] However, patients may be prone to develop complications due to some factors, including variability in pelvic anatomy, the narrowness of the bone corridor to be screwed, and inadequacies in imaging and Objectives: This study aims to determine the role of computed tomography (CT)-derived templates, produced by threedimensional (3D) modeling, image processing and printing technology, in percutaneous transsacral screw fixation and evaluate the effects of their use on surgical success. Materials and methods: This prospective study conducted between June 2018 and December 2019 utilized 15 composite pelvis models for transsacral-transiliac screw fixation. For the procedure, modeled templates were utilized for wiring on the left side of the pelvis models, while the conventional method was performed on the right side of the pelvis models. In the computed tomography images acquired after wiring, appropriate wire position was evaluated. Results: The placed wires held the S1 body appropriately in all of the procedures with or without template use. With the template use, the wires were placed appropriately in the surgical bone corridor suitable for the transsacral-transiliac screw fixation in all of the models. However, with the conventional methods, the wires were not placed in the safe surgical bone corridor in four models. The wire deviation angle in the axial plane was significantly lower in the template group (p=0.001), whereas it was not different between the template group and the conventional method group in the coronal plane (p=0.054). The amount of deviation from the ideal wire entry site was significantly reduced in the template group compared to the conventional method group (p=0.001). Conclusion: With the use of 3D modeling and printing technology, CT-derived templates can be produced and utilized for transsacral screw fixation procedures and their use increases surgical success by reducing the surgical margin of error.

A Systematic Review and Meta-Analysis of 3D Printing Technology for the Treatment of Acetabular Fractures

“…The application of 3D printing technology varies from anatomical models mainly intended for preoperative planning to surgical guides and implants [ 8 , 9 ]. 3D imaging can be used to assist CT scans to accurately visualize the fracture patterns [ 10 , 11 ] and reduce the surgical margin of error [ 12 ]. Preoperative planning is a critical procedure of acetabular surgery and can also be assisted with 3D printing technology.…”

Does a Customized 3D Printing Plate Based on Virtual Reduction Facilitate the Restoration of Original Anatomy in Fractures?

“…To address these limitations, studies have utilized 3D printing technology in fracture surgeries. The application of 3D printing in fractures varies widely from 3D modeling for screw fixation to customized casting [ 20 , 21 ]. The existing works on 3D printing fracture plates can be largely divided into tactile modeling and mirroring of the normal contralateral bone.…”