2022, Vol. 26 ›› Issue (18): 2823-2827

3D printing technology assisted traditional plate fixation for the treatment of complex tibial plateau fractures

Wang Sizhe1, Gao Kunfan2, Xu Zhenzhen3, Gao Haiyan4, Huang Haoran5, Dai Shiyou6, Ma Jianlin1, Wang Feng7   

Abstract: BACKGROUND: Traditional steel plate internal fixation, the common clinical standard procedure, is nothing new in treating fracture of tibia. The preoperative solid model, however, produced by 3D printing technology, works better in resetting the fracture, and is much safe, accurate and individualized, in contrast to classical approach.   
OBJECTIVE: To explore the clinical effect and application value of 3D printing technology in healing complex tibial fractures.
METHODS:   Two groups, 3D group and control group, were divided by 40 cases of unilateral tibial fractures that accepted surgical treatment at Qingdao Hospital of Shandong First Medical University from June 2017 to June 2019. Traditional surgical fixation method was applied to the control group, while the 3D group, however, received operations guided by the preoperative operation of 3D printed solid models, combining the model to perform preoperative simulated reduction and plate internal fixation to guide the actual surgical operation. All patients accepted a 12-month follow-up of comparing the operation time, intraoperative blood loss, intraoperative fluoroscopy times, knee Rasmussen radiology performance on the 3rd day after surgery, and knee HSS score 12 months later.   
RESULTS AND CONCLUSION: (1) All 40 patients were treated ideally and received an effective follow-up visit for more than 12 months. There were no complications such as vascular and nerve injury, and no rejection reactions related to internal fixation materials. (2) Outcomes, such as operation time, intraoperative blood loss, and intraoperative fluoroscopy were less in the 3D group than those in the control group (P < 0.05). Knee Rasmussen radiology performance on the 3rd day after surgery was higher in the 3D group than that of the control group (P < 0.05). There was no significant difference in knee HSS score between the two groups at 12 months (P > 0.05). (3) Results indicate that in terms of complex tibial fractures treatment, 3D printing shines on significantly shortening the operation time, reducing intraoperative blood loss and fluoroscopy times, and enhancing knee function.
Key words: tibial plateau fracture, 3D printing, clinical efficacy, plate, internal fixation, traditional surgery