Application of 3D printing technology in treatment of acetabular posterior wall fractures

Abstract

Objective To evaluate the preliminary application of 3D printing technology in the treatment of acetabular posterior wall fractures. Methods A retrospective study was conducted to analyze the 34 patients who had been admitted for acetabular posterior wall fracture between January 2014 to April 2015. They were 18 men and 16 women, from 21 to 65 years of age. According to the Letournel-Judet classification, there were 17 cases of posterior wall fracture, 11 ones of posterior column + posterior wall fracture, and 6 ones of transverse + posterior wall fracture. Of them, 15 used 3D printing technology to fabricate individualized 3D fracture models for preoperative planning, including 7 men and 8 women, with an average age of 45.1±14.2 years. The other 19 cases underwent conventional surgery without aid by 3D printing technology, including 11 men and 8 women, with an average age of 43.7±13.2 years. All the patients were treated by internal fixation through the Kocher-Langenbeck approach with AO mini plate combined with reconstruction plate. The 2 groups were compared in terms of operation time, intraoperative bleeding, intraoperative fluoroscopy frequency, fracture reduction, hip joint function at the last follow-up and postoperative complications. Results All the patients were followed up for an average of 11.1 months (range, from 3 to 16 months) . The operation time for the 3D group (83.2±13.5 min) was significantly shorter than that for the conventional group (96.8±13.1 min) , the intraoperative bleeding (257.3±54.7 mL) and the intraoperative fluoroscopy frequency (2.7±0.8 times) in the 3D group were significantly less than those in the conventional group (327.1±70.4 mL; 3.3±0.9 times) (P 0.05). Conclusion In the treatment of acetabular posterior wall fractures, 3D printing is an effective adjuvant technique which can reduce operation time, intraoperative blood loss, and intraoperative fluoroscopy frequency. Key words: Acetabulum; Fractures, bone; Fracture fixation, internal; Surgery, computer-assisted; 3D printing technology