Application of 3D printing and computer-assisted surgical simulation in preoperative planning for acetabular fracture

LIU Xin; ZENG Canjun; LU Jiansen; LIN Xuchen; HUANG Huajun; TAN Xinyu; CAI Daozhang

doi:10.3969/j.issn.1673-4254.2017.03.17

Abstract：Objective To evaluate the feasibility and effectiveness of using 3D printing and computer-assisted surgical simulation in preoperative planning for acetabular fractures.Methods A retrospective analysis was performed in 53 patients with pelvic fracture,who underwent surgical treatment between September,2013 and December,2015 with complete follow-up data.Among them,19 patients were treated with CT three-dimensional reconstruction,computer-assisted virtual reset internal fixation,3D model printing,and personalized surgery simulation before surgery (3D group),and 34 patients underwent routine preoperative examination (conventional group).The intraoperative blood loss,transfusion volume,times of intraoperative x-ray,operation time,Matta score and Merle D' Aubigne & Postel score were recorded in the 2 groups.Preoperative planning and postoperative outcomes in the two groups were compared.Results All the operations were completed successfully.In 3D group,significantly less intraoperative blood loss,transfusion volume,fewer times of x-ray,and shortened operation time were recorded compared with those in the conventional group (P＜0.05).According to the Matta scores,excellent or good fracture reduction was achieved in 94.7％ (18/19) of the patients in 3D group and in 82.4％ (28/34) of the patients in conventional group;the rates of excellent and good hip function at the final follow-up were 89.5％ (17/19) in the 3D group and 85.3％ (29/34) in the conventional group (P＞0.05).In the 3D group,the actual internal fixation well matched the preoperative design.Conclusions 3D printing and computer-assisted surgical simulation for preoperative planning is feasible and accurate for management of acetabular fracture and can effectively improve the operation efficiency.