Three-Dimensional Computer-Assisted Surgical Planning and Use of Three-Dimensional Printing in the Repair of a Complex Articular Femoral Fracture in a Dog

Griselda Lam,Sun-Young Kim

doi:10.1055/s-0038-1676062

Abstract

Objective The main purpose of this study was to describe the use and benefits of 3-dimensional (3D) computer-assisted surgical planning (CASP) and printing in a complex articular fracture repair in a dog. Study Design Case report. Animals Client-owned dog. Results One dog with a closed, severely comminuted, distal femoral supracondylar and bicondylar fracture underwent a preoperative computed tomography scan. Three-dimensional CASP was performed using computer-aided design software. Three-dimensional CASP allowed for visualization of the fracture fragments and virtual surgery, including reduction of the fragments and implant placement. A 3D model of the affected femur was printed and a bone plate was pre-contoured to the model. Intraoperative fracture reduction and stabilization were performed without complications. Postoperative radiographs revealed successful execution of the planned procedure. Subsequent radiographs and clinical examination indicated that bone healing was achieved with return to normal function of the limb. Three-dimensional CASP and the printed 3D model allowed for improved understanding of the anatomical relationship between fracture fragments, preoperative implant selection and contouring, and the ability to practice fracture reduction and implant placement preoperatively. The model was also used for client education, and to teach students and residents. Conclusion Three-dimensional CASP and printed models are valuable tools in the preoperative planning of complex fracture repairs, educating clients and teaching students and residents.

Highlights

Femoral fractures are frequently encountered in clinical small animal practice, accounting for 45% of all long bone fractures.[1,2] Trauma is a common cause of femoral fractures, such as vehicular accidents or falls from great heights
Threedimensional computer-assisted surgical planning (CASP) allowed for visualization of the fracture fragments and virtual surgery, including reduction of the fragments and implant placement
Three-dimensional CASP and the printed 3D model allowed for improved understanding of the anatomical relationship between fracture fragments, preoperative implant selection and contouring, and the ability to practice fracture reduction and implant placement preoperatively

Summary

Introduction

Femoral fractures are frequently encountered in clinical small animal practice, accounting for 45% of all long bone fractures.[1,2] Trauma is a common cause of femoral fractures, such as vehicular accidents or falls from great heights. A small subset includes those fractures that affect the supracondylar and condylar regions, representing 8 to 10% of all femoral fractures.[1,2,3,4] These fractures pose unique challenges to veterinary surgeons due to the limited bone stock available for fixation and articular involvement, requiring anatomical reconstruction and rigid fixation via interfragmentary compression.[5] a received August 8, 2018 accepted after revision October 10, 2018.

Results

Discussion

Conclusion