Abstract
Objective To investigate the effect and safety of 3D printing technology in proximal femoral osteotomy in children with developmental dysplasia of the hip. Methods 40 cases of children with developmental dysplasia of the hip treated by pelvic osteotomy combined with proximal femoral osteotomy at Ningbo No. 6 Hospital from January 2017 to December 2019 were retrieved and retrospectively analyzed. Among them, 20 cases received preoperative measurement and design assisted by 3D printing technology (the 3D printing group), and 20 cases received conventional preoperative measurement and design (the conventional group). Results All patients were followed up for an average of 25 (12~36) months. During the follow-up, there were no complications such as infection, fracture of internal fixation, or malunion of osteotomy. Compared with the conventional group, the 3D printing group had a shorter operation time, less intraoperative blood loss, and fewer intraoperative X-ray fluoroscopies (all p < 0.05). In the last follow-up, the clinical efficacy was evaluated by the McKay standard: in the 3D printing group, 14 cases were excellent, 5 cases were good, and 1 case was fair. In the conventional group, 10 cases were excellent, 9 cases were good, and 1 case was fair (Z = −0.382, p > 0.05). Conclusion Preoperative 3D printing of bilateral femur and other large physical models is accurate, which is ideal for the development of individual preoperative planning. Proximal femoral osteotomy using preoperative measurements and simulated surgical data improves the safety of the operation.
Highlights
Developmental dysplasia of the hip (DDH) is a common hip deformity in children, and pelvic osteotomy combined with proximal femoral rotation, varus, and shortening osteotomy is a commonly used surgical treatment [1, 2]
Older than 2 years, surgical treatment is the better option, and the purpose of treatment is to achieve the reduction of concentric circles of the acetabulum, so as to restore the normal anatomical structure of the hip joint and the optimal joint function, which is the key to the postoperative evaluation of the treatment effect [10, 11]
Because there is no accurate method to measure the femoral neck anteversion during routine surgery, the best angle of rotation is determined by the surgeons according to their experience during the operation, which obviously lacks accuracy and consistency, affects the surgical results, and limits the development of surgical techniques
Summary
To investigate the effect and safety of 3D printing technology in proximal femoral osteotomy in children with developmental dysplasia of the hip. 40 cases of children with developmental dysplasia of the hip treated by pelvic osteotomy combined with proximal femoral osteotomy at Ningbo No 6 Hospital from January 2017 to December 2019 were retrieved and retrospectively analyzed. In the last follow-up, the clinical efficacy was evaluated by the McKay standard: in the 3D printing group, 14 cases were excellent, 5 cases were good, and 1 case was fair. 10 cases were excellent, 9 cases were good, and 1 case was fair (Z = −0:382, p > 0:05). Proximal femoral osteotomy using preoperative measurements and simulated surgical data improves the safety of the operation
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