Journal Article

Three-dimensional printing of patient-specific plates for the treatment of acetabular fractures involving quadrilateral plate disruption

Chen, Yuhui, Wang, Liping, Liu, Han, Chen, Jiahui, Wen, Xiangyuan, Gu, Cheng, Liu, Yuancheng, Huang, Wenhua, Lin, Xuezhi, Wang, Di, Dong, Jianghui, Yao, Lufeng, Fan, Shicai, Wang, Canbin, Huang, Fuming

2020

Overview

Background Complicated acetabular fractures comprise the most challenging field for orthopedists. The purpose of this study was to develop three-dimensional printed patient-specific (3DPPS) Ti-6Al-4 V plates to treat complicated acetabular fractures involving quadrilateral plate (QLP) disruption and to evaluate their efficacy. Methods Fifty patients with acetabular fractures involving QLP disruption were selected between January 2016 and June 2017. Patients were divided into a control group (Group A, 35 patients) and an experimental group (Group B, 15 patients), and were treated by the conventional method of shaping reconstruction plates or with 3DPPS Ti-6AL-4 V plates, respectively. The efficacy of Ti-6AL-4 V plates was evaluated by blood loss, operative time, reduction quality, postoperative residual displacement, and complications. Results The operative time and blood loss in Group B were reduced compared to Group A, and the difference was statistically significant ( P  < 0.05). There was no significant difference in reduction quality between the two groups ( P  > 0.05). Reduction quality in Group B was anatomic in 10 (66.7%), satisfactory in four (26.7%), and poor in one (6.7%). In Group A, they were anatomic in 18 (51.4%), satisfactory in 13 (37.1%), and poor in four (11.4%). Residual displacement in Group B was less than that in Group A, and the difference was statistically significant ( P  < 0.05). In Group B, one case exhibited loosening of the pubic screw postoperatively. In Group A, there was one case of wound infection, one of deep vein thrombosis (DVT) in the ipsilateral lower limb, one case of traumatic arthritis and two obturator nerve injuries. Conclusions The 3DPPS Ti-6AL-4 V plate is a feasible, accurate and effective implant for acetabular fracture treatment.

• Publisher: BioMed Central,BioMed Central Ltd,Springer Nature B.V,BMC
• Subject: 3D printing / 3D printing patient-specific plates / Acetabular fractures / Acetabulum / Acetabulum - diagnostic imaging / Acetabulum - surgery / Arthritis / Biomechanics / Bone Plates / Design / Epidemiology / Fracture Fixation, Internal / Fractures / Fractures, Bone - diagnostic imaging / Fractures, Bone - surgery / Hip Fractures / Hip joint / Humans / Internal Medicine / Medical imaging / Medicine / Medicine & Public Health / Orthopedics / Orthopedics and biomechanics / Patient-specific implants / Patients / Pelvis / Physical therapy / Printing, Three-Dimensional / Quadrilateral plate disruption / Rehabilitation / Research Article / Rheumatology / Software / Sports Medicine / Statistical analysis / Surgical techniques / Thrombosis / Virtual surgical planning / Wound infection / X-rays