Abstract
Purpose The aim of this study was to assess the feasibility and effectiveness of the three-dimensional (3D) printing technology in the treatment of Pilon fractures. Methods 100 patients with Pilon fractures from March 2013 to December 2016 were enrolled in our study. They were divided randomly into 3D printing group (n = 50) and conventional group (n = 50). The 3D models were used to simulate the surgery and carry out the surgery according to plan in 3D printing group. Operation time, blood loss, fluoroscopy times, fracture union time, and fracture reduction as well as functional outcomes including VAS and AOFAS score and complications were recorded. To examine the feasibility of this approach, we invited surgeons and patients to complete questionnaires. Results 3D printing group showed significantly shorter operation time, less blood loss volume and fluoroscopy times, higher rate of anatomic reduction and rate of excellent and good outcome than conventional group (P < 0.001, P < 0.001, P < 0.001, P = 0.040, and P = 0.029, resp.). However, no significant difference was observed in complications between the two groups (P = 0.510). Furthermore, the questionnaire suggested that both surgeons and patients got high scores of overall satisfaction with the use of 3D printing models. Conclusion Our study indicated that the use of 3D printing technology to treat Pilon fractures in clinical practice is feasible.
Highlights
Tibia Pilon fractures are complex injuries constituting 1% of all lower-extremity fractures and 5% to 10% of tibia fractures [1]
There were 48 patients remaining in the conventional group and 45 patients in the 3D printing group
The fracture was on the right in 28 patients and the left in 20
Summary
Tibia Pilon fractures are complex injuries constituting 1% of all lower-extremity fractures and 5% to 10% of tibia fractures [1]. These fractures often result from high-energy trauma leading to multiple metaphyseal fragments, bone loss, displaced intra-articular comminution, and severe soft tissue injuries, which makes them one of the most difficult fractures to treat [2]. The aim of operative treatment is anatomic reduction of the articular fragments and restoration of the distal tibial alignment while avoiding additional soft tissue trauma [3]. Various complications, including soft tissue problems, delayed union, nonunion, malunion, implant failure, joint stiffness, and posttraumatic arthritis, may arise after surgery if not treated properly, which results in severe pain and affects the motor functions of the patients [6, 7]
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