Our experience in 3D-modelling in pilon (distal tibial plafond) fractures

Abstract

BACKGROUND: Internal fixation of pilon fractures remains challenging despite the development of new technologies in medical imaging and implant design and various scientific investigations on this problem. A key point in therapeutic strategy is preoperative planning. Since the beginning of the twenty-first century, the procedure has changed dramatically from plain radiograph drawing to 3D models and internal fixation simulation in vitro. AIM: This study aimed to evaluate 3D modeling in pilon fracture osteosynthesis preoperative planning. MATERIALS AND METHODS: The study used open, prospective, randomized, and comparative analysis. We analyzed the data of 60 patients with pilon fractures who had undergone surgical treatment for pilon fractures between July 1, 2020, and December 12, 2021, in Moscow City Hospital No. 17. In 30 patients, 3D models were used in preoperative planning, and in another 30 patients, the traditional planning method was performed. The operation time, intraoperation, X-ray dosage, blood loss, fracture reduction quality, and long-term results were analyzed. Additionally, the surgeon’s comfort in applying the 3D model and ease of doctor–patient communication were assessed using questionnaires. RESULTS: Results showed that 3D modeling in pilon fracture osteosynthesis preoperative planning has advantages over traditional preoperative planning. CONCLUSION: Therefore, 3D planning is a promising novel method for distal tibial fracture internal fixation preoperative planning, which provides significant higher degree of fracture anatomy comprehension and facilitates reduction maneuvers and implant positioning.