Efficacy of virtual surgical planning and a three‐dimensional‐printed, patient‐specific reduction system to facilitate alignment of diaphyseal tibial fractures stabilized by minimally invasive plate osteosynthesis in dogs: A prospective clinical study
Logan M. Scheuermann,
Daniel D. Lewis,
Matthew D. Johnson
et al.
Abstract:ObjectiveTo evaluate the efficacy of a three‐dimensional (3D)‐printed, patient‐specific reduction system for aligning diaphyseal tibial fractures stabilized using minimally invasive plate osteosynthesis (MIPO).Study designProspective clinical trial.Sample populationFifteen client owned dogs.MethodsVirtual 3D models of both pelvic limbs were created. Pin guides were designed to conform to the proximal and distal tibia. A reduction bridge was designed to align the pin guides based on the guides' spatial location… Show more
ObjectiveTo compare the efficacy and clinical outcomes of computed tomography (CT)‐based virtual surgical planning (VSP) and a three‐dimensional (3D)‐printed, patient‐specific reduction system to conventional indirect reduction techniques for diaphyseal tibial fractures stabilized using minimally invasive plate osteosynthesis (MIPO) in dogs.Study designA prospective clinical study with a historic control cohort.Sample populationDogs undergoing MIPO stabilization of diaphyseal tibial fractures using a custom 3D‐printed reduction system (3D‐MIPO; n = 15) or conventional indirect reduction techniques (c‐MIPO; n = 14).MethodsDogs were prospectively enrolled to the 3D‐MIPO group and CT scans were used to design and fabricate a custom 3D‐printed reduction system to facilitate MIPO. Medical records were searched to identify dogs for the c‐MIPO group. Pre‐, intra‐ and postoperative parameters were compared between groups.ResultsThe duration from presentation until surgery was 23 h longer in the 3D‐MIPO group (p = .002). Fewer intraoperative fluoroscopic images were acquired (p < .001) and mean surgical duration was 34 min shorter in the 3D‐MIPO group (p = .014). Median postoperative tibial length, frontal alignment, and sagittal alignment were within 4 mm, 3° and 3°, respectively, of the contralateral tibia in both groups and did not differ between reduction groups (p > .1). Postoperative complications occurred in 27% and 14% of fractures in the 3D‐MIPO and c‐MIPO groups, respectively.ConclusionBoth reduction methods yielded comparable results. Although the preoperative planning and guide preparation was time consuming, surgery times were shorter and fluoroscopy use was less in the 3D‐MIPO group.Clinical significanceVSP and the custom 3D‐printed reduction system facilitated efficient MIPO.
ObjectiveTo compare the efficacy and clinical outcomes of computed tomography (CT)‐based virtual surgical planning (VSP) and a three‐dimensional (3D)‐printed, patient‐specific reduction system to conventional indirect reduction techniques for diaphyseal tibial fractures stabilized using minimally invasive plate osteosynthesis (MIPO) in dogs.Study designA prospective clinical study with a historic control cohort.Sample populationDogs undergoing MIPO stabilization of diaphyseal tibial fractures using a custom 3D‐printed reduction system (3D‐MIPO; n = 15) or conventional indirect reduction techniques (c‐MIPO; n = 14).MethodsDogs were prospectively enrolled to the 3D‐MIPO group and CT scans were used to design and fabricate a custom 3D‐printed reduction system to facilitate MIPO. Medical records were searched to identify dogs for the c‐MIPO group. Pre‐, intra‐ and postoperative parameters were compared between groups.ResultsThe duration from presentation until surgery was 23 h longer in the 3D‐MIPO group (p = .002). Fewer intraoperative fluoroscopic images were acquired (p < .001) and mean surgical duration was 34 min shorter in the 3D‐MIPO group (p = .014). Median postoperative tibial length, frontal alignment, and sagittal alignment were within 4 mm, 3° and 3°, respectively, of the contralateral tibia in both groups and did not differ between reduction groups (p > .1). Postoperative complications occurred in 27% and 14% of fractures in the 3D‐MIPO and c‐MIPO groups, respectively.ConclusionBoth reduction methods yielded comparable results. Although the preoperative planning and guide preparation was time consuming, surgery times were shorter and fluoroscopy use was less in the 3D‐MIPO group.Clinical significanceVSP and the custom 3D‐printed reduction system facilitated efficient MIPO.
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