Abstract
BackgroundDelayed reconstruction of acetabular fractures remains a challenging task for orthopedists because of malunion, fracture line absorption, and scar formation. Accurate osteotomy, interfragmentary release, and proper adaptation of plates are keys to successful surgery. Prevention of superior gluteal artery (SGA) injury induced by cleaning of the osteotylus and reduction of the sciatic notch is also important. Therefore, sufficient preoperative planning is essential. However, traditional planning methods do not readily provide direct visual and tactile feedback to surgeons. Rapid prototyping (RP) models have provided new opportunities in the preoperative planning of delayed reconstruction of acetabular fractures. We hypothesized that a three-dimensional (3D) skeleton-arterial model would improve both preoperative planning in the management of fractures and arteries and intraoperative assistance during delayed reconstruction of complex acetabular fractures.MethodsEight patients were enrolled in this study. Data on the skeleton and arteries were obtained from computed tomography and angiography scans and used to produce RP models. Preoperative surgical planning and intraoperative assistance were performed using these models as references.ResultsAll 3D skeleton-arterial models were extremely accurate. Reduction and fixation were performed programmatically and smoothly, and management of the SGA was reliably executed according to a thorough preoperative plan. The mean surgical time and intraoperative blood loss were 224.4 min and 1250 ml, respectively. Among the eight patients, four underwent anatomic reduction and five had excellent functional outcomes at the final follow-up. No significant complications occurred.ConclusionsThis 3D skeleton-arterial model is helpful for orthopedists in preoperative planning and intraoperative assistance.
Highlights
Delayed reconstruction of acetabular fractures remains a challenging task for orthopedists because of malunion, fracture line absorption, and scar formation
Proper adaptation of reconstruction plates is important for successful recreation of the normal anatomical structure
Using the 3D skeleton-arterial model, the fracture morphology and arterial trend could be clearly observed without obscuration of the femoral head (Fig. 3)
Summary
Delayed reconstruction of acetabular fractures remains a challenging task for orthopedists because of malunion, fracture line absorption, and scar formation. We hypothesized that a three-dimensional (3D) skeleton-arterial model would improve both preoperative planning in the management of fractures and arteries and intraoperative assistance during delayed reconstruction of complex acetabular fractures. Damage to the SGA secondary to cleaning of the scar/osteotylus and reduction of the sciatic notch may have serious consequences [9,10,11,12] These complex procedures are associated with an increased surgical time and greater intraoperative blood loss. Proper morphometric evaluation and sufficient preoperative planning are essential before delayed reconstruction of acetabular fractures is begun
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
