3D PRINTING PREOPERATIVE PLANNING AND CUSTOMIZED SURGICAL GUIDES ASSOCIATED WITH O-ARM NAVIGATION SYSTEM FOR MULTIPLANAR OSTEOTOMY OF COMPLEX PELVIC DEFORMITY

Abstract

Abstract INTRODUCTION 3D printing technology is penetrating the healthcare field at an astonishing rate. The reduction of its costs, makes it more accessible to everyone. MATERIAL AND METHODS 35-year-old woman who had functional limitation in her right hip due to pelvic ring fracture in her childhood. She had dysmetria of lower limbs and femoral anteversion of 40 degrees. Imaging tests showed vicious consolidation of the right hemipelvis associated with antero-medial displacement. RESULTS Preoperative, we performed her 3D printing pelvic ring model. Osteotomies were digital planned (iliac crest, superior pubic ramus, incomplete of inferior pubic ramus, and semicircular of posterior column) and also how many degrees we would need for rotation the osteotomized fragment. Posterior column osteotomy was the most difficult, so we designed 3D surgical printing cutting guide able to being inserted into the iliac fossa. We used it to introduced four Kirschnner wires that leads us as a guide to avoid the greater sciatic notch. O-arm navigation system helped us make sure to achieve more precision. 3D printing pelvic ring model was sterilized to pre-contouring osteosynthesis plates. After two years of follow-up, good functional results were observed, without gait claudication either limb dysmetria. Her range of motion is 105 degrees of hip flexion, 20 degrees of internal hip rotation and 40 degrees of external hip rotation. Complete radiological consolidation was observed. CONCLUSION Digital planning and 3D printing technology allows to improve three-dimensional compression of bone pathology leading to a higher likelihood of a predictable ideal outcome compared to conventional techniques.