3D-print in the planning of surgical treatment in the case of extraarticular deformity of lower limbs

Abstract

An adequate planning of the curative measures is an important factor providing good functional results in the treatment of consequences of long bones injuries, in particular, malunions (post traumatic deformities). 3D-modeling in the preoperative planing gives an opportunity to assess both deformity itself and joint status. Visua­lization of injured segment with three-dimensional model manufactured using 3D-print in actual size (1:1 scale) provides additional capacities. Objective. To analyze the capacity provided by the usage of three-dimensional models of damaged segments in scale 1:1 while the planning of corrective surgery. Methods. Practicability of the usage of 3D-models, that was worked out on the base of CT-scanning, was studied in the treatment of 52 patients with different post traumatic extraarticular deformities of femur and tibia, after the fractures with intraarticular extension. Clinical results were evaluated using SF-36 and AOFAS scales. Results. Calculation for 3D-modeling was performed mostly virtually using standard computer programs with 3D-reconstruction, but 3D-print technology was used for 5 patients with the most severe and sophisticated deformities of the lower extremities. Changes in functional outcomes, according to SF-36 and AOFAS, for the patients undergone opera- tive treatment, were positive at 12 month of follow-up. Fore­ign colleagues expose analogous results of the investigations and suggest that the modeling with 3D-print provides mostly more safe, reliable and standardized clinical decisions for every particular patient. Conclusions. Preoperative usage of 3D-print on the stage of preoperative planing allows the surgeons to simulate different stages of operative intervention on the physical model, thus, help him to realize possible technical problems, choose adequate fixation device and proper instrumentation. It facilitates the shortening of surgery time, elimination of possible complications rate and achievement, in sum, good functional results in the treatment of this kind of patients.