A new universal 3D-printable device to prevent excessive drilling in orthopedic surgery
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ORIGINAL ARTICLE
A new universal 3D‑printable device to prevent excessive drilling in orthopedic surgery Joan Ferràs‑Tarragó1 · Pablo Jordà‑Gómez1 · Juan Català‑de‑las‑Marinas1 · Juan Manuel Antequera‑Cano1 · Mariano Barrés‑Carsí1 Received: 2 May 2020 / Accepted: 13 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Introduction The occurrence of vascular injury during drilling is a rare but severe complication. Unfortunately, drilling protection systems are not available in all hospitals. Thanks to the development of 3D printing in recent years, sharing devices and materials to solve surgical problems has become easy and inexpensive. The objective of our work is to evaluate a universal, freely accessible, 3D-printable drilling protection device. Materials and methods A prospective, randomized, and triple-blind evaluation of excess drilling was evaluated in expert surgeons and resident surgeons without the use of the protection device. Subsequently, excess drilling was assessed using the device in both groups. The differences in drilling lengths between both groups with and without the device were analyzed to establish the reduction of excess drilling in both groups. Results The drilling in the expert surgeon without device group was 3.03 mm (SD 1.69 95% CI 2.40–3.66 p value = 9.89e−11), while the resident surgeon with device group performed excess drilling of 1.76 mm (SD 0.89 CI 95% 1.43–2.10). Results showed better results in the resident surgeon with device group than in the expert surgeons with device group (p value ˂ 0.01). The device improved drilling in both resident surgeons (5.77 mm) and expert surgeons (1.17 mm). Conclusions The device improves drilling in both expert surgeons and resident surgeons, showing greater benefits in the latter. The device is printable with any 3D printer, making it universally accessible, inexpensive, and effective, allowing expert surgeons to improve precision in high-risk situations and resident surgeons to improve their technique without increasing risk to the patient. Keywords 3D printing · Vascular damage · Hip fracture · 3D devices
Introduction Fractures of the proximal femur affect ~ 3.5% of men and 14.6% of women throughout their adult life [1]. Its incidence increases year by year due to the progressive aging of the world’s population, with a projected 100% increase in prevalence in the first half of the 21st century [2–5]. The primary treatment of hip fractures is surgery, with conservative treatment reserved for those patients at high surgical risk due to their comorbidities or for nondisplaced intracapsular fractures in selected patients [3, 6–10]. Of the surgical implant options available, sliding hip screws * Joan Ferràs‑Tarragó [email protected] 1
La Fe Hospital, Av Fernando Abril Martorell 106, 46026 Valencia, Spain
and intramedullary nails are the two most frequently used options [9, 11, 12], with the use of cannulated screws being much less frequent [13]. Vascular injury is one of the least frequent and most seve
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