A feasibility study into the use of three-dimensional printer modelling in acetabular fracture surgery.
Bottom Line: There are a number of challenges associated with the operative treatment of acetabular fractures.This leads to a reduction in the associated soft tissue trauma, reduced intraoperative time and blood loss, minimal handling of the plate, and reduced fluoroscopic screening times.We feel that the use of this technology to customize implants, plates, and the operative procedure to a patient's unique anatomy can only lead to improved outcomes.
Affiliation: St Mary's Hospital, London W2 1NY, UK.
There are a number of challenges associated with the operative treatment of acetabular fractures. The approach used is often extensive, while operative time and perioperative blood loss can also be significant. With the proliferation of 3D printer technology, we present a fast and economical way to aid the operative planning of complex fractures. We used augmented stereoscopic 3D CT reconstructions to allow for an appreciation of the normal 3D anatomy of the pelvis on the fractured side and to use the models for subsequent intraoperative contouring of pelvic reconstruction plates. This leads to a reduction in the associated soft tissue trauma, reduced intraoperative time and blood loss, minimal handling of the plate, and reduced fluoroscopic screening times. We feel that the use of this technology to customize implants, plates, and the operative procedure to a patient's unique anatomy can only lead to improved outcomes.
No MeSH data available.
Related in: MedlinePlus
Mentions: In 2013, we identified two patients who presented to our level one major trauma centre with both column fractures of the left acetabulum. In both cases there was associated quadrilateral plate and posterior column displacement allowing for joint subluxation. Patient 1 was a forty-eight-year-old male who sustained the injury from a motorcycle accident in the Sahara Desert. Patient 2 was a fifty-six-year-old diabetic patient who presented after a mechanical fall whilst attempting to jump off a boat. Both had comminuted fractures of the left acetabulum as isolated injuries that were visualised on X-ray and CT (Figures 1, 2(a), 2(b), 3, 4(a), and 4(b)). The CT scans taken at the time of presentation were taken with conventional 16-detector CT scanners and included 0.625 mm axial sections that were used to reconstruct a 3D model of the pelvis. The uninjured right hemipelvis of the model was reflected and reformatted to model an uninjured left hemipelvis. Two trajectories were superimposed on this model to simulate screws from a pelvic brim plate that could lag the posterior column fragment, avoiding displacement of the posterior wall fragment and any intra-articular penetration. The DICOM imaging files were converted to STL to enable printing on an Objet Eden 250 printer utilising selective laser sintering of Objet MED610 polymer (Stratasys Inc., Rehovot, Israel). The printing process depended on the size of the desired output. Thus in order to minimize the printing time to less than 8 hours, we only printed what was strictly required. Our model exhibited the mirror image of the uninjured hemipelvis and extended from the sacroiliac joint to the pubic symphysis (Figure 4(a)).
No MeSH data available.