Management of Complex Acetabular Fractures by Using 3D Printed Models

Abstract

Background and Objectives: Using 3D printed models in orthopaedics and traumatology contributes to a better understanding of injury patterns regarding surgical approaches, reduction techniques, and fracture fixation methods. The aim of this study is to evaluate the effectiveness of a novel technique implementing 3D printed models to facilitate the optimal preoperative planning of the surgical treatment of complex acetabular fractures. Materials and Methods: Patients with complex acetabular fractures were assigned to two groups: (1) conventional group (n = 12) and (2) 3D printed group (n = 10). Both groups included participants with either a posterior column plus posterior wall fracture, a transverse plus posterior wall fracture, or a both-column acetabular fracture. Datasets from CT scanning were segmented and converted to STL format, with separated bones and fragments for 3D printing in different colors. Comparison between the two groups was performed in terms of quality of fracture reduction (good: equal to, or less than 2 mm displacement, and fair: larger than 2 mm displacement), functional assessment, operative time, blood loss, and number of intraoperative x-rays. Results: A significant decrease in operative time, blood loss, and number of intraoperative x-rays was registered in the 3D printed group versus the conventional one (p < 0.01), with 80% of the patients in the former having good fracture reduction and 20% having fair reduction. In contrast, 50% of the patients in the conventional group had good reduction and 50% had fair reduction. The functional score at 18-month follow-up was better for patients in the 3D printed group. Conclusions: The 3D printing technique can be considered a highly efficient and patient-specific approach for management of complex acetabular fractures, helping to restore patient′s individual anatomy after surgery.

The Possibilities of Personalized 3D Printed Implants—A Case Series Study

“…We could have planned an operation using an “ice-cream cone prosthesis” with a stem placed in the iliac wing [ 57 ]; however, the anatomically high center of rotation and limb length discrepancy—with risks of instability and recurrent dislocation—led us to the decision of applying a patient-specific 3D printed prosthesis. In such cases, adequate stabilization is achieved by complete closing of the defect and placing the desired number of screws in the proper locations [ 2 ]. In addition, since the joint rotation center is kept in its anatomical position, the function is better, with no leg-length discrepancy.…”

“…Following the most recent software and 3D printing developments, the use of personalized orthopedic implants for treatment of complex surgical cases has gained more popularity. The modern 3D printing technology has contributed to (1) better understanding of complex bone fracture patterns, (2) standardization of the surgical procedures, and (3) proper implant positioning in preclinical studies [ 1 , 2 , 3 ].…”

3D printing in biomedicine: advancing personalized care through additive manufacturing

“…Following the most recent software and 3D printing developments, the use of personalized orthopedic implants to treat complex surgical cases has gained more popularity. In orthopedics, 3D printing has revolutionized the approach to bone replacements [51,52]. Traditional implants may not always align perfectly with a patient's anatomy, leading to potential complications and discomfort.…”

“…This personalized approach contributes to better implant integration, reduced post-operative complications, and improved patient outcomes. The advent of modern 3D printing technology has made significant contributions to the field of orthopedics, particularly in enhancing our comprehension of intricate bone fracture patterns, streamlining surgical procedures, and ensuring precise implant placement in preclinical investigations [52,53]. In the realm of orthopedic practice, a diverse array of implants is readily available for standardized surgeries related to bone substitution across various anatomical regions of the human body.…”