Treatment of old acetabular posterior wall fracture with 3D printing combined with composite plate internal fixation.
10.3969/j.issn.1003-0034.2019.05.002
- Author:
Xiao-Zhen WANG
;
Zhen SHI
;
Qi-Lin LU
;
Wei XIE
;
Long CHEN
;
Xu-Gui LI
;
Xue-Zhen SHAO
;
Yi-Liang ZHU
;
Yan-Jun ZHONG
;
Xi-Ming LIU
1
,
2
;
Xian-Hua CAI
Author Information
1. Department of Orthopaedics, Wuhan General Hospital of PLA, Wuhan 430071, China
2. gklxm@163.com.
- Publication Type:Journal Article
- Keywords:
Acetabular;
Fracture fixation, internal;
Fractures;
Printing, three-dimensional
- MeSH:
Acetabulum;
Adolescent;
Adult;
Aged;
Bone Plates;
Female;
Fracture Fixation, Internal;
Fractures, Bone;
Humans;
Male;
Printing, Three-Dimensional;
Treatment Outcome;
Young Adult
- From:
China Journal of Orthopaedics and Traumatology
2019;32(5):395-400
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE:To explore the application value and clinical effect of three-dimensional printing combined with composite plate internal fixation in the treatment of old acetabular posterior wall fracture.
METHODS:From May 2010 to October 2016, Mimics 19.0 software was used to plan preoperatively according to a 1:1 print pelvic 3D model. At the same time, 23 patients with old acetabular posterior wall fractures were treated with combined plate internal fixation, including 15 males and 8 females, aged 20 to 63 (43.0±5.1) years old, and the time from injury to operation was 23 to 101(47.0±10.5) days. According to Letournel-Judet classification, 11 cases were posterior wall fracture, 7 cases were transverse with posterior wall fracture, and 5 cases were posterior column with posterior wall fracture. All patients were treated with single Kocher-Langenbeck approach combined plate internal fixation, and the evaluation indexes were recorded during operation, after operation and during follow-up.
RESULTS:The operation time of 23 patients was (113.5±11.5) min, bleeding was (550.0±104.7) ml and fluoroscopy was (12.7±0.8) s. Matta radiographic reduction criteria were used: excellent in 14 cases, good in 7 cases and poor in 2 cases; 23 patients were followed up for 10 to 24 (16.0±5.6) months. The hip function was evaluated according to the modified Merle d'Aubingne and Postal scoring system at the last follow-up: excellent in 11 cases, good in 8 cases, fair in 3 cases and poor in 1 case. There were 3 cases of traumatic arthritis, 1 case of femoral head necrosis, 2 cases of heterotopic ossification and 5 cases of sciatic nerve irritation.
CONCLUSIONS:3D printing technique is an effective and fast method for the treatment of old acetabular posterior wall fractures. In addition, the printing model can provide three-dimensional morphological structure for the operator, combined with preoperative simulation, facilitate intraoperative reduction, and effectively improve the efficiency of surgery.
