BACKGROUND: Complex pelvic fractures present the orthopaedic surgeon with many challenges. 3-D printed models may provide assistance in pre-operative planning, may lead to improvements in intra-operative (i) decision making and (ii) efficiencies (time reduction, blood loss reduction, screening reduction) and may result in improvements in post-operative outcomes (fracture reduction & quality of life). The models also provide hands-on opportunities for orthopaedic trainees and patients. This may result in improvements in (i) education/training regarding the management of pelvic and acetabular fractures for orthopaedic trainees and (ii) improvements in patient consenting and overall patient satisfaction. DESIGN: Single-centre, two orthopaedic surgeons (pelvic and acetabular fellowship trained), prospective observational study. Twenty patients with acute displaced pelvic/acetabular fracture(s); ten 3-D-printed pelvis and ten non-printed cases for comparison. The comparison cohorts were matched for fracture classification, sex and age. OUTCOME MEASURES: Classification assistance, intra-operative time, estimated blood loss, screening amount, post-operative reduction and infection, EQ-5D-5L, teaching/educational assistance and pre-operative counselling. RESULTS: The models provided more information regarding fracture pattern, however, this did not result in change of CT-planned approach/procedure or patient outcomes. The models scored highly on surgeon's questionnaire. The models were found to have a positive impact on trainee education and patient consenting/counselling. With regard to objective comparisons, there was no significant improvements in time-to-surgery, intra-operative time, estimated blood loss, screening amount, fracture reduction or infection rate. There was no significant difference in quality of life questionnaire ~ 12 months post-surgery (statistical tests used; Cohen's effect size and Fisher's exact test). CONCLUSIONS: Whilst the authors recognize the positive subjective findings with respect to the use of 3-D printing in pelvic and acetabular trauma in our National Centre, objective findings were lacking.
BACKGROUND: Complex pelvic fractures present the orthopaedic surgeon with many challenges. 3-D printed models may provide assistance in pre-operative planning, may lead to improvements in intra-operative (i) decision making and (ii) efficiencies (time reduction, blood loss reduction, screening reduction) and may result in improvements in post-operative outcomes (fracture reduction & quality of life). The models also provide hands-on opportunities for orthopaedic trainees and patients. This may result in improvements in (i) education/training regarding the management of pelvic and acetabular fractures for orthopaedic trainees and (ii) improvements in patient consenting and overall patient satisfaction. DESIGN: Single-centre, two orthopaedic surgeons (pelvic and acetabular fellowship trained), prospective observational study. Twenty patients with acute displaced pelvic/acetabular fracture(s); ten 3-D-printed pelvis and ten non-printed cases for comparison. The comparison cohorts were matched for fracture classification, sex and age. OUTCOME MEASURES: Classification assistance, intra-operative time, estimated blood loss, screening amount, post-operative reduction and infection, EQ-5D-5L, teaching/educational assistance and pre-operative counselling. RESULTS: The models provided more information regarding fracture pattern, however, this did not result in change of CT-planned approach/procedure or patient outcomes. The models scored highly on surgeon's questionnaire. The models were found to have a positive impact on trainee education and patient consenting/counselling. With regard to objective comparisons, there was no significant improvements in time-to-surgery, intra-operative time, estimated blood loss, screening amount, fracture reduction or infection rate. There was no significant difference in quality of life questionnaire ~ 12 months post-surgery (statistical tests used; Cohen's effect size and Fisher's exact test). CONCLUSIONS: Whilst the authors recognize the positive subjective findings with respect to the use of 3-D printing in pelvic and acetabular trauma in our National Centre, objective findings were lacking.
Authors: Matthew S Manganaro; Yoav Morag; William J Weadock; Corrie M Yablon; Kara Gaetke-Udager; Erica B Stein Journal: Radiographics Date: 2017 May-Jun Impact factor: 5.333
Authors: Marcelo Galvez; Takeshi Asahi; Alejandro Baar; Giovanni Carcuro; Natalio Cuchacovich; Jorge A Fuentes; Rodrigo Mardones; Carlos E Montoya; Roberto Negrin; Felipe Otayza; Gonzalo M Rojas; Andrés Chahin Journal: J Am Acad Orthop Surg Glob Res Rev Date: 2018-05-17