3D printing technology in the treatment of traumatic hip fracture with the help of 3D-CT classification

Abstract

Objective To evaluate 3D print model and spiral 3D-CT reconstruction parting in hip fracture diagnostic and therapeutic application value. Methods A retrospective study was performed on diagnosis by 3D print model, 3D-CT and X-ray of 46 patients with hip joint fracture.According to the model of 3D printing, X-ray imaging, the 3D-CT imaging data, fracture classification according to the following standards: Type Ⅰ, acetabulum fracture without displacement; Type Ⅱ, acetabulum anterior column and(or)front wall fracture displacement less than 4 mm, column and(or)wall fracture displacement less than 4 mm, top of the acetabulum fracture displacement less than 2 mm; Type Ⅲ, acetabulum anterior column and(or)front wall fracture displacement more than 4 mm, wall column and(or)after fracture displacement more than 4 mm, top of the acetabulum fracture displacement more than 2 mm; Type Ⅳ, double column or T fracture, fracture type central dislocation; Type Ⅴ, acetabulum fracture combination of femoral neck fracture and(or)intra-articular loose bodies, pelvic fractures.Patients with Type Ⅰ and Ⅱ received conservative treatment, such as traction, patients with Type Ⅲ, Ⅳ, Ⅴ received anterior or posterior surgery.All patients were followed up for 6 months on average, and follow-up data was integrity.Harris score method was used to evaluate the function of hip joint. Results There was significant difference between X-ray and 3D model(P=0.012), there was no significant difference between CT and 3D model(P=0.083). Type Ⅰ was 3 cases, Type Ⅱ was 5 cases, Type Ⅲ was 16 cases, Type Ⅳ was 12 cases, Type Ⅴ was 10 cases.According to Harris score, excellent was 35 cases, good was 7 cases, fair was 4 cases, and the excellent and good rate was 91%; there was no significant difference in the long-term excellent and good rate of patients with Type Ⅲ, Ⅳ, Ⅴ(P=0.102, 0.079, 0.059). Conclusion The traditional Jndt and Letoume1 classification process is complicated and the angle has certain limitation, which has not considered the acetabulum weight-bearing area fracture, the joint free bone block as well as the head and neck, the pelvis fracture and so on.Three-dimensional reconstruction spiral CT classification has some guiding significance for the clinical treatment of hip fracture. Key words: Fracture of hip joint; 3D print technology; X-ray; Three-dimensional reconstruction spiral CT