Abstract
Background and Purpose Hip dislocation combined with acetabular fracture remains a challenging condition for orthopedic surgeons. In this study, we utilized a computer-assisted simulation and three-dimensional (3D) printing technology to treat patients with hip dislocation combined with acetabular fracture. We hypothesized that the 3D printing-assisted method would shorten the internal fixation time and surgical time. Methods We retrospectively reviewed 16 patients diagnosed with traumatic posterior dislocation of hip combined with acetabular fractures and treated with plate fixation from September 2013 to August 2017. Patients were divided into two groups: (1) traditional method and (2) 3D printing groups. In the traditional method group, the plates were contoured during the surgery, whereas in the 3D printing group, the patient's pelvic computed tomography image was transformed to the 3D medical image software for processing preoperatively. The fracture reduction was simulated by the computer. Thereafter, the 1:1 scale 3D printing model was used to design the surgical plan and contour patient-specific plates preoperatively. Results The internal fixation time was significantly shorter in the 3D printing group than in the traditional method group (-33 min, P<0.05). The mean operative time was shorter than that in the traditional method group (-43 min). However, blood loss and postoperative radiograph results were similar between the groups. The complication rate was lower in the 3D printing group (2/7) than in the traditional method group (5/9). Interpretation Computer-assisted simulation with 3D printing technology is a more efficient method for treating hip dislocation combined with acetabular fractures.
Highlights
Hip dislocations combined with acetabular fractures are typically caused by high-energy trauma, usually from motor vehicle accidents
The exclusion criteria were (1) stable hip joint by examination under anesthesia after closed reduction of the hip, (2) acetabular fractures fixed with other implants, (3) fracture dislocations with concomitant preoperative neurovascular injury, and (4) acetabular fractures combined with pelvic iliac wing fractures
One and two patients underwent open reduction and internal fixation for femoral head fracture in the traditional method and 3D printing groups, respectively
Summary
Hip dislocations combined with acetabular fractures are typically caused by high-energy trauma, usually from motor vehicle accidents. Fractures of the posterior wall of the acetabulum are one of the most common types of acetabular fractures, accounting for up to 30% of all acetabular fractures [1] These severe injuries often require urgent closed reduction of the hip and surgery to restore hip joint stability and articular surface anatomically. Stable and anatomic fixation for fractured posterior wall and column can provide hip stability. Upex et al [5] reported a surgical technique for treating fractures of both columns of the acetabulum with precontouring plates obtained using the 3D-printing model. In this study, patients with acetabular fractures combined with hip dislocation were treated using traditional plate fixation methods or using preoperative contoured plates in the 3D printing model. We aimed to compare surgical and clinical outcomes between the traditional and 3D printing simulation methods
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