3D printing combined with anteroposterior cannulated screws for the treatment of posterolateral tibial plateau fracture

Zhihao Shen; Yingying Zhang; Feng Wu; Hua Chen; Huaizhi Ge

doi:10.1186/s12891-023-06887-9

3D printing combined with anteroposterior cannulated screws for the treatment of posterolateral tibial plateau fracture

BMC Musculoskelet Disord. 2023 Oct 6;24(1):796. doi: 10.1186/s12891-023-06887-9.

Authors

Zhihao Shen^#¹, Yingying Zhang^#², Feng Wu¹, Hua Chen¹, Huaizhi Ge³

Affiliations

¹ Department of Orthopaedics Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, NO.109, XueYuan West Road, Luheng District, Wenzhou, 325000, Zhejiang Province, P.R. China.
² Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, NO.109, XueYuan West Road, Luheng District, Wenzhou, 325000, Zhejiang Province, P.R. China.
³ Department of Radiology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, NO.109, XueYuan West Road, Luheng District, Wenzhou, 325000, Zhejiang Province, P.R. China. gehuaizhi@wmu.edu.cn.

^# Contributed equally.

Abstract

Purpose: This study aimed to compare the effects of conventional surgery and three-dimension (3D) printing technology-assisted surgery in the treatment of posterolateral tibial plateau fractures (PTPF).

Methods: A cohort of 61 patients afflicted with PTPF, spanning from June 2015 to October 2021, was enrolled. They were divided randomly into two groups: 31 cases of 3D printing group, 30 cases of conventional group. The personalized 3D-printed models were used to simulate the surgical procedures in 3D printing group. The demographic characteristics and clinical data were recorded, encompassing operation duration, intraoperative blood loss, intraoperative fluoroscopy shoots and fracture union time. The radiographic outcomes were gauged, encompassing tibiofemoral angle (FTA), tibial plateau angle (TPA), posterolateral slope angle (PSA) and Rasmussen's anatomical score. The functional outcomes were assessed at the 12-month postoperative juncture, encompassing range of motion, Hospital for Special Surgery (HSS) score and Rasmussen's functional score. Furthermore, fracture complications were evaluated,, encompassing infections, traumatic osteoarthritis, and delayed union.

Results: The 3D printing group exhibited the operation time of 95.8 ± 30.2 min, intraoperative blood loss of 101.1 ± 55.3 ml, and intraoperative fluoroscopy shoots of 6.3 ± 2.3 times, while the conventional group recorded respective values of 115.5 ± 34.0 min, 137.0 ± 49.2 ml and 9.13 ± 2.5 times. Noteworthy disparities were evident between the conventional and 3D printing groups (p < 0.05). Furthermore, in comparison to the conventional group, the 3D printing group exhibited commendable radiological and functional outcomes both immediately and 12 months post-surgery, although statistical significance was not attained. Moreover, the 3D printing group experienced a paucity of complications compared to the conventional group, although without achieving statistical significance.

Conclusion: This study demonstrated the clinical feasibility of 3D printing combined with anteroposterior cannulated screws for the treatment of posterolateral tibial plateau fracture.

Keywords: 3D printing; Orthopedics; Posterolateral tibial plateau fracture; Surgery.

MeSH terms

Blood Loss, Surgical
Fracture Fixation, Internal / methods
Humans
Printing, Three-Dimensional
Retrospective Studies
Tibial Fractures* / diagnostic imaging
Tibial Fractures* / surgery
Tibial Plateau Fractures*
Treatment Outcome