Abstract
Purpose To investigate the clinical effect of novel patient-specific 3D printing templates based on external fixation for pelvic screw insertion compared with the fluoro-navigation technique. Materials and methods We retrospectively studied 18 pelvic fracture patients from July 2017 to July 2018. For analysis, patients were divided into two groups: the template group (15 screws in 8 patients) and the fluoro-navigation group (22 screws in 10 patients). The screw insertion time, radiation exposure time, and accuracy of the screw insertion as evaluated by postoperative CT scans were analyzed. Results In the template group, the average screw insertion time (11.5 ± 2.3 min/screw) was significantly 50.6% less than that in the fluoro-navigation group (23.3 ± 3.1 min/screw; P < 0.05). The average time of X-ray exposure in the template group (11.5 ± 3.9 s/screw) was also significantly 39.8% less than in the fluoro-navigation group (19.1 ± 2.5 s/screw; P < 0.05). In the template group, the mean deviation distance and angle between the actual and planned screw position was 2.6 ± 0.2 mm and 2 ± 0.3°. Conclusions The patient-specific template based on external fixation can guide the insertion of the pelvic screw accurately and safely while significantly reducing operation and radiation exposure time.
Highlights
Pelvic fracture accounts for 2–8% of all fractures [1]
(2) Methods: We retrospectively studied 8 patients with pelvic fractures who were treated using this novel template from July 2017 to July 2018
(4) Conclusions: The patient-specific template based on external fixation can guide the insertion of the pelvic screw accurately, safely and invasively and significantly reduce operation and radiation exposure time
Summary
Unstable pelvic ring fracture require fixation to restore stability [2]. As open reduction and internal fixation with plates may lead to secondary damage, excess intraoperative blood loss, and iatrogenic injury of the nerve and blood vessels, most practitioners [3, 4] recommend percutaneous screw fixation to treat the pelvic fractures when applicable because that technique provides adequate biomechanical stability in non-displaced or minimally displaced fractures [5, 6, 7]. With the development of the fluoro-navigation system, the minimally invasive percutaneous screw technique has become a safe, more accurate, and fairly quick method to treat pelvic ring fracture [9]. The high cost and complexity of the setup of the navigation system have limited its widespread application in intermediate and primary care hospitals
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