Personalized Three‐Dimensional Printed Anterior Titanium Plate to Treat Double‐Column Acetabular Fractures: A Retrospective Case‐Control Study

Abstract

Objective To compare the clinical efficacy and safety of a personalized three‐dimensional (3D) printed dynamic anterior plate–screw system for the quadrilateral area (DAPSQ) titanium plate and a traditional DAPSQ reconstruction plate in the treatment of double‐column acetabular fractures. Methods This was a retrospective case‐control study. From May 2014 to January 2018, 43 patients with double‐column acetabular fractures underwent open reduction and internal fixation. Among these, 20 cases were fixed with a 3D printed DAPSQ plate (3D printed group) and 23 cases were fixed with a DAPSQ reconstruction plate (control group). The 3D printed group comprised 15 men and 5 women, with an average age of 50.1 ± 8.2 years. The control group comprised 16 men and 7 women, with an average age of 51.0 ± 8.6 years. The evaluation index included the surgical data (i.e. blood loss, operating time, duration of hospital stay, and intraoperative and postoperative complications), position and length of implants, reduction quality, hip function, and related complications. The reduction quality was evaluated using the Matta scoring standard and hip function was evaluated using the modified Merle d’Aubigné score. Results A total of 43 patients met the inclusion criteria. The mean postoperative follow up was 35.2 months in the 3D printed group and 36.9 months in the control group. There were no significant group differences in demographic data between the two groups. The position and length of the 3D printed implants were generally in accord with preoperative planning using a 3D pelvic model. Patients in the 3D printed group had significantly shorter operation time (223.2 vs 260.5 min, P < 0.05) and less intraoperative blood loss (930.4 vs 1426.1 mL, P < 0.05) compared to the control group. Anatomic, imperfect, and poor reduction was obtained in 13, 5, and 2 cases in the 3D printed group, respectively, and was obtained in 12, 8, and 3 cases in the control group. The modified Merle d’Aubigné scores were excellent in 11 cases, good in seven cases, and fair in two cases in the 3D printed group. They were excellent in 11 cases, good in eight cases, fair in three cases, and poor in one case in the control group. The reduction quality and hip function did not differ within the groups (P > 0.05). The general complication rate in the 3D printed group and the control group was 15% and 26.1%, respectively, but the difference between the two groups was not statistically significant. Conclusion Use of a personalized 3D printed DAPSQ plate has potential advantages in reducing the operation time and blood loss during the treatment of double‐column acetabular fractures.

Complications of Acute Acetabular Fractures Surgical Treatment: Systematic Review

“…Мы понимаем, что приведенные цифры не могут отражать в полной мере реальную статистику. К сожалению, не все авторы отражают в своих исследованиях количество выполненных доступов [18,21,40,41], приводя лишь данные о количестве выполненных операций. Другие авторы приводят данные о редких комбинациях новых доступов [26], что не позволяет их учитывать из-за ограниченных возможностей нашего исследования.…”

Does 3D-Assisted Acetabular Fracture Surgery Improve Surgical Outcome and Physical Functioning?—A Systematic Review

“…Three randomised controlled trials [38,43,44], one prospective cohort study [40], ten case control studies [30][31][32]34,35,41,42,[45][46][47], and five case series [29,33,36,37] were included. The methodological quality of the papers varied from low (Table 3) to good (Table 4).…”

“…Nine of these full-text articles were excluded due to the following reasons: foreign language article on 3D printing and pre-contouring the implant (N = 1); case reports (N = 2); descriptive study (N = 1); biomechanical study (N = 1); conference abstract (N = 1); outcome measurements unclear (N = 3). In total, 19 studies met the inclusion criteria for this systematic review (Figure 1) [29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]. The included studies enrolled a total of 753 patients (median sample size 27; range 10-146).…”

Current trends in the treatment of acetabular fractures (literature review)

“…Фіксацію фрагментів здійснюють за допомогою реконструктивних пластин і гвинтів у різних комбінаціях. Актуальності на-буває використання індивідуальних металевих конструкцій, виготовлених з урахуванням анатомічних особливостей і характеру перелому шляхом 3D-друку з титану [27].…”