Role of 3D printing in the management of complex acetabular fractures: a comparative study
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ORIGINAL ARTICLE
Role of 3D printing in the management of complex acetabular fractures: a comparative study Sajid Ansari1 · Sitanshu Barik1 · Sanny Kumar Singh1 · Bhaskar Sarkar1 · Tarun Goyal2 · Roop Bhushan Kalia1 Received: 5 May 2020 / Accepted: 1 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The aim of this study is to assess the role of 3D printing of actual size pelvis in the management and outcome of acetabular fractures. Methods Retrospective study with inclusion of acetabular fractures which were divided into two groups (traditional and 3D printing) was done over a 1 year period. The indices for comparison of both groups in this study were (a) operative time (from skin incision to suture), (b) intraoperative blood loss (noted from the anaesthetist notes), (c) times of intraoperative fluoroscopy, (d) postoperative complications, (e) quality of fracture reduction (good = 2 mm displacement) and (f) Harris hip score at final follow-up. Results 27 cases (traditional group = 15, 3D printing group = 12) meeting the study criteria were included in the study with a mean follow-up of 26.3 ± 11.2 months. There was a significant difference in the operative time, intraoperative blood loss and number of intraoperative fluoroscopy images. The mean operative time was shorter in the 3D printing group by 62 min. No difference was noted in the quality of reduction in either of the groups (p > 0.05). Conclusion 3D imaging and printing helps in better understanding of the anatomy of acetabular fractures. It leads to reduced operative time, blood loss as well as exposure to radiation intraoperatively. There is no difference in functional outcome at final follow-up between 3D printing and traditional groups. Keywords Acetabular fractures · 3D printing · Operative time · Blood loss
Introduction Acetabular fractures are one of the most challenging to treat in traumatology in view of the complex anatomy of the acetabulum, its limited and technically demanding exposure with numerous neurovascular structures present in its vicinity and the numerous postoperative complications associated with it [1]. Displaced fractures in the weight bearing regions of acetabulum must require operative intervention for joint congruity and subsequent optimal hip function [2]. For an acceptable reduction, the surgeon must be well versed with the anatomy of the fracture with its type, extent and presence or absence of any intra-articular bony fragments and * Roop Bhushan Kalia [email protected] 1
Department of Orthopedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
Department of Orthopaedics, All India Institute of Medical Sciences, Bhatinda, India
2
moreover, no standard universal implant for such fractures is available which makes the surgery more demanding even for an experienced surgeon. Contouring of plates and measurement of screw length may take up additional time, along with increased blood loss, during the surgical procedure. The use of 3D bone
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