3D Printing Technology In Treatment Research Articles

Efficacy and Prognosis of 3D Printing Technology in Treatment of High-Energy Trans-Syndesmotic Ankle Fracture Dislocation - "Log-Splitter" Injury.

BackgroundThis study aimed to retrospectively assess the feasibility and efficacy of three-dimensional (3D) printing technology in the treatment of high-energy trans-syndesmotic ankle fracture dislocation – “log-splitter” injury – and to evaluate the efficacy and prognosis.Material/MethodsWe included 29 patients (17 males and 12 females; mean age, 44.0±13.2 years) with log-splitter injury from June 2011 to December 2016, divided into a routine group (n=13) and a 3D printing group (n=16) according to the surgical method used. Operation time, intraoperative blood loss, fluoroscopy times, fracture union time, functional outcomes based on AOFAS (American Orthopedic Foot and Ankle Society) score, and postoperative complications were observed and recorded.ResultsCompared with the routine treatment group, 3D printing technology had better safety and efficacy for the treatment of log-splitter injury and the advantages of shorter operation time, less intraoperative blood loss, fewer fluoroscopies needed, and higher rate of good functional outcome (P<0.001, P<0.001, P<0.001, and P=0.017, respectively). However, no significant difference was noted in the rate of anatomical reduction, mean AOFAS score at the last follow-up (mean time, 19.9±2.8 months), or postoperative complications between the 2 groups (P=0.370, P=0.156, and P=0.485, respectively).ConclusionsSurgery assisted by 3D printing technology to treat log-splitter injury is feasible and effective, and may be a good optional approach to formulate a reasonable personalized surgical plan and to optimize the outcomes.

The Patient-Specific Implant Created with 3D Printing Technology in Treatment of the Irreparable Radial Head in Chronic Persistent Elbow Instability

Successful treatment of the chronic persistent elbow instability is a challenge for orthopedic surgeons. In this form, it is important to recognize and restore the osseous stabilizer in order to obtain the concentric reduction. In the present report, we describe a case of such injury with irreparable radial head treated with patient-specific radial head prosthesis which was created with 3D printing technology. To our knowledge, this is the first report in clinical use of this kind of prosthesis for the radial head fracture. At a 24-month follow-up visit, the patient was satisfied with the functional outcomes. The Mayo Elbow Performance Index (MEPI) increased from 20 points at the preoperative day to 85 points, and the patient-based Disabilities of the Arm, Shoulder, and Hand (DASH) was reduced from 88.33 points to 28.33 points. Due to the favorable result, replacement of the radial head with the patient-specific implant could be a useful treatment for the irreparable radial head in chronic persistent elbow instability.

Application of three-dimensional printing technology in treatment of internal or external ankle distal avulsed fracture

To explore the effectiveness and advantage of three-dimensional (3D) printing technology in treatment of internal or external ankle distal avulsed fracture. Between January 2015 and January 2017, 20 patients with distal avulsed fracture of internal or external ankle were treated with the 3D guidance of shape-blocking steel plate fixation (group A), and 18 patients were treated with traditional plaster external fixation (group B). There was no significant difference in gender, age, injury cause, disease duration, fracture side, and fracture type between 2 groups ( P>0.05). Recording the fracture healing rate, fracture healing time, the time of starting to ankle functional exercise, residual ankle pain, and evaluating ankle function recovery of both groups by the American Orthopaedic Foot and Ankle Society (AOFAS) score. All patients were followed up 8-24 months, with an average of 15.5 months. In group A: all incisions healed by first intention, the time of starting to ankle functional exercise was (14±3) days, fracture healing rate was 100%, and the fracture healing time was (10.15±2.00) weeks. At 6 months, the AOFAS score was 90.35±4.65. Among them, 13 patients were excellent and 7 patients were good. All patients had no post-operative incision infection, residual ankle pain, or dysfunction during the follow-up. In group B: the time of starting to ankle functional exercise was (40±10) days, the fracture healing rate was 94.44%, and the fracture healing time was (13.83±7.49) weeks. At 6 months, the AOFAS score was 79.28±34.28. Among them, 15 patients were good, 2 patients were medium, and 1 patient was poor. During the follow-up, 3 patients (16.67%) had pain of ankle joint with different degrees. There were significant differences in the postoperative fracture healing rate, fracture healing time, the time of starting to ankle functional exercise, and postoperative AOFAS score between 2 groups ( P<0.05). Application of 3D printing technology in treatment of internal or external ankle distal avulsed fracture is simple, safe, reliable, and effective. In particular, it is an ideal treatment for avulsed fracture.

L’impression 3D dans le traitement des fractures inter-condyliennes de l’humerus

Purpose of the studyThis study was aimed to compare conventional surgery and surgery assisted by 3D printing technology in the treatment of humeral intercondylar fractures. In addition, we also investigated the effect of 3D printing technology on the communication between doctors and patients. Material and methodsA total of 91 patients with humeral intercondylar fracture were enrolled in the study from March 2013 to August 2015. They were divided into two groups: 43 cases of 3D printing group, 48 cases of conventional group. The individual models were used to simulate the surgical procedures and carry out the surgery according to plan. Operation duration, blood loss volume, fluoroscopy times and time to fracture union were recorded. The final functional outcomes, including the motion of the elbow, MEPS and DASH were also evaluated. Besides, we made a simple questionnaire to verify the effectiveness of the 3D-printed model for both doctors and patients. ResultsThe operation duration, blood loss volume and fluoroscopy times for 3D printing group was 76.6±7.9minutes, 231.1±18.1mL and 5.3±1.9 times, and for conventional group was 92.0±10.5minutes, 278.6±23.0mL and 8.7±2.7 times respectively. There was statistically significant difference between the conventional group and 3D-printing group (P<0.05). However, no significant difference was noted in the final functional outcomes between the two groups. Furthermore, the questionnaire showed that both doctors and patients exhibited high scores of overall satisfaction with the use of a 3D-printing model. DiscussionsThis study suggested the clinical feasibility of 3D-printing technology in treatment of humeral intercondylar fractures. Level of evidenceLevel II prospective randomized study.

Application of 3D-printing technology in the treatment of humeral intercondylar fractures.

This study was aimed to compare conventional surgery and surgery assisted by 3D-printing technology in the treatment of humeral intercondylar fractures. In addition, we also investigated the effect of 3D-printing technology on the communication between doctors and patients. A total of 91 patients with humeral intercondylar fracture were enrolled in the study from March 2013 to August 2015. They were divided into two groups: 43 cases of 3D-printing group, 48 cases of conventional group. The individual models were used to simulate the surgical procedures and carry out the surgery according to plan. Operation duration, blood loss volume, fluoroscopy times and time to fracture union were recorded. The final functional outcomes, including the motion of the elbow, MEPS and DASH were also evaluated. Besides, we made a simple questionnaire to verify the effectiveness of the 3D-printed model for both doctors and patients. The operation duration, blood loss volume and fluoroscopy times for 3D-printing group was 76.6±7.9minutes, 231.1±18.1mL and 5.3±1.9 times, and for conventional group was 92.0±10.5minutes, 278.6±23.0mL and 8.7±2.7 times respectively. There was statistically significant difference between the conventional group and 3D-printing group (p<0.05). However, No significant difference was noted in the final functional outcomes between the two groups. Furthermore, the questionnaire showed that both doctors and patients exhibited high scores of overall satisfaction with the use of a 3D-printing model. This study suggested the clinical feasibility of 3D-printing technology in treatment of humeral intercondylar fractures. Level II prospective randomized study.

Comparison of the Conventional Surgery and the Surgery Assisted by 3d Printing Technology in the Treatment of Calcaneal Fractures

ABSTRACTPurpose: This study was aimed to compare conventional surgery and surgery assisted by 3D printing technology in the treatment of calcaneal fractures. In addition, we also investigated the effect of 3D printing technology on the communication between doctors and patients. Methods: we enrolled 75 patients with calcaneal fracture from April 2014 to August 2016. They were divided randomly into two groups: 35 cases of 3D printing group, 40 cases of conventional group. The individual models were used to simulate the surgical procedures and carry out the surgery according to plan in 3D printing group. Operation duration, blood loss volume during the surgery, number of intraoperative fluoroscopy and fracture union time were recorded. The radiographic outcomes Böhler angle, Gissane angle, calcaneal width and calcaneal height and final functional outcomes including VAS and AOFAS score as well as the complications were also evaluated. Besides, we made a simple questionnaire to verify the effectiveness of the 3D-printed model for both doctors and patients. Results: The operation duration, blood loss volume and number of intraoperative fluoroscopy for 3D printing group was 71.4 ± 6.8 minutes, 226.1 ± 22.6 ml and 5.6 ± 1.9 times, and for conventional group was 91.3 ± 11.2 minutes, 288.7 ± 34.8 ml and 8.6 ± 2.7 times respectively. There was statistically significant difference between the conventional group and 3D printing group (p < 0.05). Additionally, 3D printing group achieved significantly better radiographic results than conventional group both postoperatively and at the final follow-up (p < 0.05). However, No significant difference was noted in the final functional outcomes between the two groups. As for complications, there was no significant difference between the two groups. Furthermore, the questionnaire showed that both doctors and patients exhibited high scores of overall satisfaction with the use of a 3D printing model. Conclusion: This study suggested the clinical feasibility of 3D printing technology in treatment of calcaneal fractures.

Application of 3D printing technology in treatment of acetabular posterior wall fractures

Objective To evaluate the preliminary application of 3D printing technology in the treatment of acetabular posterior wall fractures. Methods A retrospective study was conducted to analyze the 34 patients who had been admitted for acetabular posterior wall fracture between January 2014 to April 2015. They were 18 men and 16 women, from 21 to 65 years of age. According to the Letournel-Judet classification, there were 17 cases of posterior wall fracture, 11 ones of posterior column + posterior wall fracture, and 6 ones of transverse + posterior wall fracture. Of them, 15 used 3D printing technology to fabricate individualized 3D fracture models for preoperative planning, including 7 men and 8 women, with an average age of 45.1±14.2 years. The other 19 cases underwent conventional surgery without aid by 3D printing technology, including 11 men and 8 women, with an average age of 43.7±13.2 years. All the patients were treated by internal fixation through the Kocher-Langenbeck approach with AO mini plate combined with reconstruction plate. The 2 groups were compared in terms of operation time, intraoperative bleeding, intraoperative fluoroscopy frequency, fracture reduction, hip joint function at the last follow-up and postoperative complications. Results All the patients were followed up for an average of 11.1 months (range, from 3 to 16 months) . The operation time for the 3D group (83.2±13.5 min) was significantly shorter than that for the conventional group (96.8±13.1 min) , the intraoperative bleeding (257.3±54.7 mL) and the intraoperative fluoroscopy frequency (2.7±0.8 times) in the 3D group were significantly less than those in the conventional group (327.1±70.4 mL; 3.3±0.9 times) (P 0.05). Conclusion In the treatment of acetabular posterior wall fractures, 3D printing is an effective adjuvant technique which can reduce operation time, intraoperative blood loss, and intraoperative fluoroscopy frequency. Key words: Acetabulum; Fractures, bone; Fracture fixation, internal; Surgery, computer-assisted; 3D printing technology