Xu Chen1, Xuanhuang Chen1, Guodong Zhang2, Haibin Lin3, Zhengxi Yu1, Changfu Wu1, Xing Li1, Yijun Lin1, Wenhua Huang4. 1. Department of Orthopedics, Putian College Affiliated Hospital, Putian 351100, China. 2. Department of Orthopedics, Putian College Affiliated Hospital, Putian 351100, China; Department of Human Anatomy, Southern Medical University, School of Basic Medical Sciences, Guangzhou 510515, China. 3. Department of Orthopedics, Putian College Affiliated Hospital, Putian 351100, China. Electronic address: Lin@Medmail.com.cn. 4. Department of Human Anatomy, Southern Medical University, School of Basic Medical Sciences, Guangzhou 510515, China. Electronic address: 279352313@qq.com.
Abstract
OBJECTIVE: To investigate the feasibility of the use of 3D-printed guiding templates for accurate placement of plates and screws for internal fixation of acetabular fractures. METHODS: 3D models of the pelvises of 14 adult cadavers were reconstructed using computed tomography (CT). Twenty-eight acetabular fractures were simulated and placement positions for plates and screw trajectories were designed. Bending module was obtained by 3D cutting; guiding template was manufactured using 3D printing, and the plate was pre-bent according to the bending module. Plates and screws were placed in cadaveric pelvises using the guiding template, and 3D model was reconstructed using CT. The designed and real trajectories were matched using 3D registration including the coordinates (entry and exit points) of designed trajectory. The number of qualified points with different accuracy levels was compared using Chi-squared test. RESULTS: Sixty-four plates and 339 screws were placed with no cortical breach. The absolute difference of the X, Y, and Z coordinates between the designed and real entry points were 0.52±0.45, 0.43±0.36, and 0.53±0.44mm, respectively. The corresponding values for the exit points were 0.83±0.67, 1.22±0.87, and 1.26±0.83mm, respectively. With an accuracy degree ≥1.9mm for the entry points and ≥3.8mm for the exit points, there was no significant difference between the designed and the real trajectories. CONCLUSION: The 3D-printed guiding template helped achieve accurate placement of plates and screws in the pelvis of adult cadavers.
OBJECTIVE: To investigate the feasibility of the use of 3D-printed guiding templates for accurate placement of plates and screws for internal fixation of acetabular fractures. METHODS: 3D models of the pelvises of 14 adult cadavers were reconstructed using computed tomography (CT). Twenty-eight acetabular fractures were simulated and placement positions for plates and screw trajectories were designed. Bending module was obtained by 3D cutting; guiding template was manufactured using 3D printing, and the plate was pre-bent according to the bending module. Plates and screws were placed in cadaveric pelvises using the guiding template, and 3D model was reconstructed using CT. The designed and real trajectories were matched using 3D registration including the coordinates (entry and exit points) of designed trajectory. The number of qualified points with different accuracy levels was compared using Chi-squared test. RESULTS: Sixty-four plates and 339 screws were placed with no cortical breach. The absolute difference of the X, Y, and Z coordinates between the designed and real entry points were 0.52±0.45, 0.43±0.36, and 0.53±0.44mm, respectively. The corresponding values for the exit points were 0.83±0.67, 1.22±0.87, and 1.26±0.83mm, respectively. With an accuracy degree ≥1.9mm for the entry points and ≥3.8mm for the exit points, there was no significant difference between the designed and the real trajectories. CONCLUSION: The 3D-printed guiding template helped achieve accurate placement of plates and screws in the pelvis of adult cadavers.
Authors: Lars Brouwers; Arno Teutelink; Fiek A J B van Tilborg; Mariska A C de Jongh; Koen W W Lansink; Mike Bemelman Journal: Eur J Trauma Emerg Surg Date: 2018-06-11 Impact factor: 3.693