Traumatological Application of 3D Model in Complex Acetabular Fractures

Abstract

Three-dimensional reconstruction (3D) and rapid prototyping (RPT), starting from computed tomographic (CT) examinations, is a promising technology in traumatology. It facilitates the planning and surgical results of complex fractures. Here, we used it in a complex bilateral acetabulum fracture for the assessment of the injury type and for improving knowledge of the fracture fragments. The patient was a forty-five-year-old male, with no accompanying fractures. The solid model allowed an accurate preoperative and intraoperative planning. The 3D printed model improved the understanding of anatomy of the fractures, in order to facilitate the surgical approach and the creation of dedicated pre-shaped plates. The use of the 3D model reduced surgical time, intraoperative soft tissues damage and blood loss as well as the risk of infections. Fluoro scoping imaging was also minimized. This case highlights the importance of 3D model in the management of complex fractures. Keywords Trauma, Innovations in traumatology, Rapid prototyping, PelvisWe show our experience with 3D printing on two complex fractures of both acetabula present on the same patient (fracture patterns: two columns on the left and a T-shaped on the right). Surgery was performed in a single operative session with the continued comparison of the sterilized 3D model. The 3D-printed model allowed a faster and accurate understanding of the morphology of the fracture and a more accuratepreoperative planning. In this case, surgeons simulated the operative planning (i.e. fracture reduction, screw measurement, and plate positioning). This simulation allowed the modelling of plates before surgery, thus reducing both the operating time and fluoroscopic imaging. Case ReportIn July 2015 a forty-five-year-old male patient presented to our trauma centre for a complex bilateral acetabular fracture (Figure 1) after a car accident. The patient did not present accompanying fractures or bleedings and was hemodynamically stable. At the time of presentation, CT scans were taken with conventional 16-detector CT scanners with slice thickness of 0.625 mm. The DICOM imaging files were converted in the software Mimics (Metarialise, Leuven, Belgium) by acquisition of three 2D plans (axial, coronal, sagittal) and one 3D view. 2D CT slices have a white/black appearance referring to the density of the material. Mimics is able to isolate a particular type of material starting from a selected colour (this type of process is called thresholding). Once the material has been selected, it can be transformed into a 3D image, then the file can

Comparison of 2 open-sourced 3-dimensional modeling techniques for orthopaedic application

“…[9][10][11][12] Sterilized 3D printed models also provide tactile feedback, helping identify key landmarks during surgery and selecting patient-specific surgical guides. [13,14] These real cases can be replicated by 3D printing to facilitate clinical training.…”