Three-dimensional printing-assisted surgical technique with limited operative exposure for both-column acetabular fractures.

Abstract

It is often difficult to achieve satisfactory reduction and fixation of both-column acetabular fractures owing to the complexity of the regional anatomy of the pelvis and the fracture configuration, which is commonly associated with a high degree of comminution. Herein, we describe the use of a three-dimensional (3D) patient-specific printed model of the pelvis to facilitate preoperative planning, simulate the fracture reduction procedure, and pre-contour the fixation plates for treating both-column acetabular fractures. The 3D-printed model was constructed using a fused deposition modeling method with computed tomography images as inputs. Operative and clinical outcomes were evaluated for 5 patients with both-column acetabular fractures (mean age: 41.4 years). The status of fracture reduction was classified using the Matta criteria, and the functional outcome was assessed using the modified Merle d'Aubigne score. Reduction was classified as excellent in 4 patients and good in 1 patient, and good functional outcomes were achieved in all patients at the final follow-up. The average incision length was 6.9 cm with an average operative time of 124 min. We successfully applied 3D printing for the surgical management of both-column acetabular fractures, thereby improving surgical outcomes while achieving good-to-excellent reduction and good medium-term functional outcomes.