Percutaneous minimally invasive screwing assisted by 3D printing patient-specific external guide template for pelvic and acetabular fractures

Abstract

Objective To evaluate the efficacy and safety of 3D printing patient-specific external guide template in assisting minimally invasive screwing for treatment of pelvic and acetabular fractures. Methods The clinical and follow-up data of 39 pelvic or acetabular fractures were retrospectively analyzed which had been treated from June 2016 to February 2018 at Department of Orthopaedics, Wuhan Union Hospital. The patients were divided into a template group and a freehand group. In the template group, there were 14 men and 7 women with an age of 46.3±18.2 years and 17 pelvic fractures and 4 acetabular fractures; in the freehand group, there were 12 men and 6 women with an age of 43.8±12.2 years and 14 pelvic fractures and 4 acetabular fractures. The 2 groups were compared in terms of operation time, fluoroscopic frequency, guide wire adjustments, fracture reduction, screw penetration rate, function evaluation and adverse events. Results All the 39 patients were followed up for 9 to 13 months (average, 11.6 months). A total of 42 screws were placed in the template group and 35 screws in the freehand group. The values of operation time (43.8±22.2 min), fluoroscopic frequency (29.6±10.7 times) and guide wire adjustments (1.8±1.2 times) in the external guide template group were all significantly lower than those in the freehand group (73.8±22.6 min, 54.6±16.5 times and 9.8±2.8 times, respectively) (P 0.05). One case in the freehand group experienced numbness after operation on unilateral dorsi pedis which disappeared at 3-month follow-up. Conclusion The 3D printing patient-specific external guide template can reduce fluoroscopic frequency, save operation time and improve accuracy of screw insertion, providing a new means for minimally invasive treatment of pelvis and acetabular fractures. Key words: Pelvis; Acetabulum; Fractures, bone; Surgical procedures, minimally invasive; 3D printing technology