Efficacy and safety of 3D print-assisted surgery for the treatment of pilon fractures: a meta-analysis of randomized con
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(2018) 13:283
SYSTEMATIC REVIEW
Open Access
Efficacy and safety of 3D print-assisted surgery for the treatment of pilon fractures: a meta-analysis of randomized controlled trials Jianzhong Bai1†, Yongxiang Wang2†, Pei Zhang1, Meiying Liu1, Peian Wang3, Jingcheng Wang2* and Yuan Liang2*
Abstract Objective: To compare the effects of 3D print-assisted surgery and conventional surgery in the treatment of pilon fractures. Methods: PubMed, Embase, Web of Science, CNKI, CBM, and WanFang data were searched until July 2018. Two reviewers selected relevant studies, assessed the quality of studies, and extracted data. For continuous data, a weighted mean difference (WMD) and 95% confidence intervals (CI) were used. For dichotomous data, a relative risk (RR) and 95% CI were calculated as the summary statistics. Results: There were seven randomized controlled trials (RCT) enrolling a total of 486 patients, 242 patients underwent 3D print-assisted surgery and 244 patients underwent conventional surgery. The pooled outcomes demonstrate 3D print-assisted surgery was superior to conventional surgery in terms of operation time [WMD = − 26.16, 95% CI (− 33.19, − 19.14), P < 0.001], blood loss [WMD = − 63.91, 95% CI (− 79.55, − 48.27), P < 0.001], postoperative functional scores [WMD = 8.16, 95% CI (5.04, 11.29), P < 0.001], postoperative visual analogue score (VAS) [WMD = − 0.59, 95% CI (− 1.18, − 0.01), P = 0.05], rate of excellent and good outcome [RR = 1.20, 95% CI (1.07, 1.34), P = 0.002], and rate of anatomic reduction [RR = 1.35, 95% CI (1.19, 1.53), P < 0.001]. However, there was no significant difference between the groups regarding the rate of infection [RR = 0.51, 95% CI (0.20, 1.31), P = 0.16], fracture union time [WMD = − 0.85, 95% CI (− 1.79, 0.08), P = 0.07], traumatic arthritis [RR = 0.34, 95% CI (0.06, 2.09), P = 0.24], and malunion [RR = 0.34, 95% CI (0.06, 2.05), P = 0.24]. Conclusions: Our meta-analysis demonstrates 3D print-assisted surgery was significantly better than conventional surgery in terms of operation time, blood loss, postoperative functional score, postoperative VAS, rate of excellent and good outcome, and rate of anatomic reduction. Concerning postoperative complications, there were no significant differences between the groups. Keywords: Three-dimensional, 3D printing, Computer-assisted, Pilon fractures, Surgery
* Correspondence: [email protected]; [email protected] † Jianzhong Bai and Yongxiang Wang contributed equally to this work. 2 Clinical Medical College, Yangzhou University, Yangzhou 225001, China Full list of author information is available at the end of the article © The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were mad
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