Abstract
This paper is a systematic review of the literature on 3D-printed anatomical replicas used as templates for precontouring the fixation plates in orthopedic surgery. Embase, PubMed, Cochrane, Scopus and Springer databases were consulted for information on design study, fracture anatomical location, number of patients, surgical technique, virtual modeling approach and 3D printing process. The initial search provided a total of 496 records. After removing the duplicates, the title and abstract screening, and applying exclusion criteria and citations searching, 30 papers were declared eligible and included in the final synthesis. Seven studies were identified as focusing on retrospective non-randomized series of clinical cases, while two papers presented randomized case control studies. Two main approaches were highlighted in developing 3D-printed anatomical models for precontouring fixation plates: (a.) medical reconstruction, virtual planning and fracture reduction followed by 3D printing the model; (b.) medical reconstruction followed by 3D printing the model of the mirrored uninjured side. Revised studies reported advantages such as surgical time and blood loss reduction, while the reduction quality is similar with that of the conventional surgery. During the last couple of years there was an increase in the number of studies focused on precontouring orthopedic plates using 3D printing technology. Three-dimensionally-printed templates for plate precontouring were mostly used for acetabular fractures. Knowledge on medical virtual modeling and reconstruction is mandatory.
Highlights
In 3D printing (3DP) technology ( known as rapid prototyping (RP) or additive manufacturing (AM)) the development efforts are nowadays mostly focused on new applications and materials, as well as on enhancing the hardware and dedicated software performances [1]
The set of search keywords referred to the manufacturing process (3D printing or 3D-printed or rapid prototyping or additive manufacturing), the device of interest and the type of operation performed on the plate
3D-printed anatomical models used as templates for precontouring fixation plates in orthopedic surgeries were reported for various complex fractures, as well as in non-union cases and corrective osteotomies
Summary
In 3D printing (3DP) technology ( known as rapid prototyping (RP) or additive manufacturing (AM)) the development efforts are nowadays mostly focused on new applications and materials, as well as on enhancing the hardware and dedicated software performances [1] Following this trend, the medical domain benefits from 3DP, which better responds to the requirements of personalization (one of the keys in improving healthcare), availability and affordability than the traditional manufacturing processes [2]. The interest in a deeper study on this topic resides in the particularity of these models to be both a 1:1 replica of the patient bone anatomy and a medical device to be used pre- and intra-operative This implies specific development approaches that were identified and discussed. Discuss the review results, reported benefits and shortcomings, and preferred anatomical zones for this type of application
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