3D printing utility for surgical treatment of acetabular fractures
Preoperative 3D modelling enables more effective diagnosis and simulates the surgical procedure. We report twenty cases of acetabular fractures with preoperative planning performed by pre-contouring synthesis plates on a 3D printed mould obtained from a computerised tomography (CT) scan. The mould i...
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Published in | Revista española de cirugía ortopédica y traumatología Vol. 62; no. 4; pp. 231 - 239 |
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Main Authors | , , , |
Format | Journal Article |
Language | English |
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Spain
Elsevier España, S.L.U
01.07.2018
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Abstract | Preoperative 3D modelling enables more effective diagnosis and simulates the surgical procedure.
We report twenty cases of acetabular fractures with preoperative planning performed by pre-contouring synthesis plates on a 3D printed mould obtained from a computerised tomography (CT) scan.
The mould impression was made with the DaVinci 1.0 printer model (XYZ Printing). After obtaining the printed hemipelvis, we proceeded to select the implant size (pelvic Matta system, Stryker®) that matched the characteristics of the fracture and the approach to be used.
Printing the moulds took a mean of 385min (322–539), and 238g of plastic were used to print the model (180–410). In all cases, anatomic reduction was obtained and intra-operative changes were not required in the initial contouring of the plates. The time needed to perform the full osteosynthesis, once the fracture had been reduced was 16.9min (10–24). In one case fixed with two plates, a postoperative CT scan showed partial contact of the implant with the surface of the quadrilateral plate. In the remaining cases, the contact was complete.
In conclusion, our results suggest that the use of preoperative planning, by printing 3D mirror imaging models of the opposite hemipelvis and pre-contouring plates over the mould, might effectively achieve a predefined surgical objective and reduce the inherent risks in these difficult procedures.
La planificación y premodelado 3D nos permiten un diagnóstico más efectivo y poder realizar una simulación del procedimiento quirúrgico.
Describimos 20 fracturas de acetábulo en las que se premoldearon las placas de osteosíntesis definitivas sobre modelos obtenidos de estudios de tomografía axial computarizada (TAC) y materializados con una impresora 3D doméstica.
La impresión del molde se realiza con la impresora doméstica DaVinci 1.0 (XYZ Printing®). Tras imprimir la hemipelvis se procede a la selección de los tamaños de los implantes (pelvic Matta system, Stryker®) que más se adapten a las características de la fractura y al abordaje seleccionado.
Los minutos medios empleados para la impresión de los moldes fueron 385 (322-539), empleando como media 238g de plástico (180-410). En todos los casos se obtuvo una reducción anatómica y no fue necesario realizar modificaciones intraoperatorias en la disposición inicial de las placas. El tiempo necesario para realizar la osteosíntesis completa, una vez reducida la fractura, fue de 16.9minutos (10-24). En un caso fijado con 2 placas, el control radiológico postoperatorio mostró que una de ellas presentó un contacto parcial con la superficie de la lámina cuadrilátera. En el resto el contacto fue total.
Nuestros resultados sugieren que el uso de la planificación preoperatoria, mediante la impresión 3D de modelos especulares de hemipelvis contralaterales y el premodelado de placas de osteosíntesis sobre ellos, nos lleva a alcanzar eficientemente un objetivo quirúrgico predefinido y a reducir los riesgos inherentes de estos procedimientos complejos. |
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AbstractList | Preoperative 3D modelling enables more effective diagnosis and simulates the surgical procedure.
We report twenty cases of acetabular fractures with preoperative planning performed by pre-contouring synthesis plates on a 3D printed mould obtained from a computarized tomography (CT) scan. The mould impression was made with the DaVinci 1.0 printer model (XYZ Printing). After obtaining the printed hemipelvis, we proceeded to select the implant size (pelvic Matta system, Stryker
) that matched the characteristics of the fracture and the approach to be used.
Printing the moulds took a mean of 385minutes (322-539), and 238grams of plastic were used to print the model (180-410). In all cases, anatomic reduction was obtained and intra-operative changes were not required in the initial contouring of the plates. The time needed to perform the full osteosynthesis, once the fracture had been reduced was 16.9minutes (10-24). In one case fixed with two plates, a postoperative CT scan showed partial contact of the implant with the surface of the quadrilateral plate. In the remaining cases, the contact was complete.
In conclusion, our results suggest that the use of preoperative planning, by printing 3D mirror imaging models of the opposite hemipelvis and pre-contouring plates over the mould, might effectively achieve a predefined surgical objective and reduce the inherent risks in these difficult procedures. Preoperative 3D modelling enables more effective diagnosis and simulates the surgical procedure. We report twenty cases of acetabular fractures with preoperative planning performed by pre-contouring synthesis plates on a 3D printed mould obtained from a computerised tomography (CT) scan. The mould impression was made with the DaVinci 1.0 printer model (XYZ Printing). After obtaining the printed hemipelvis, we proceeded to select the implant size (pelvic Matta system, Stryker®) that matched the characteristics of the fracture and the approach to be used. Printing the moulds took a mean of 385min (322–539), and 238g of plastic were used to print the model (180–410). In all cases, anatomic reduction was obtained and intra-operative changes were not required in the initial contouring of the plates. The time needed to perform the full osteosynthesis, once the fracture had been reduced was 16.9min (10–24). In one case fixed with two plates, a postoperative CT scan showed partial contact of the implant with the surface of the quadrilateral plate. In the remaining cases, the contact was complete. In conclusion, our results suggest that the use of preoperative planning, by printing 3D mirror imaging models of the opposite hemipelvis and pre-contouring plates over the mould, might effectively achieve a predefined surgical objective and reduce the inherent risks in these difficult procedures. La planificación y premodelado 3D nos permiten un diagnóstico más efectivo y poder realizar una simulación del procedimiento quirúrgico. Describimos 20 fracturas de acetábulo en las que se premoldearon las placas de osteosíntesis definitivas sobre modelos obtenidos de estudios de tomografía axial computarizada (TAC) y materializados con una impresora 3D doméstica. La impresión del molde se realiza con la impresora doméstica DaVinci 1.0 (XYZ Printing®). Tras imprimir la hemipelvis se procede a la selección de los tamaños de los implantes (pelvic Matta system, Stryker®) que más se adapten a las características de la fractura y al abordaje seleccionado. Los minutos medios empleados para la impresión de los moldes fueron 385 (322-539), empleando como media 238g de plástico (180-410). En todos los casos se obtuvo una reducción anatómica y no fue necesario realizar modificaciones intraoperatorias en la disposición inicial de las placas. El tiempo necesario para realizar la osteosíntesis completa, una vez reducida la fractura, fue de 16.9minutos (10-24). En un caso fijado con 2 placas, el control radiológico postoperatorio mostró que una de ellas presentó un contacto parcial con la superficie de la lámina cuadrilátera. En el resto el contacto fue total. Nuestros resultados sugieren que el uso de la planificación preoperatoria, mediante la impresión 3D de modelos especulares de hemipelvis contralaterales y el premodelado de placas de osteosíntesis sobre ellos, nos lleva a alcanzar eficientemente un objetivo quirúrgico predefinido y a reducir los riesgos inherentes de estos procedimientos complejos. |
Author | Narbona Cárceles, F.J. Chana Rodríguez, F. Pérez Mañanes, R. Gil Martínez, P. |
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Copyright | 2018 Copyright © 2018. Publicado por Elsevier España, S.L.U. |
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DocumentTitleAlternate | Utilidad de la impresión 3D para el tratamiento quirúrgico de las fracturas acetabulares. Beca proyecto de investigación SECOT 2014 |
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Keywords | Printing Preparatorio Acetabular Fractures Placas Planificación Fracturas Preoperative Planning Impresión Acetábulo Plates |
Language | English |
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Snippet | Preoperative 3D modelling enables more effective diagnosis and simulates the surgical procedure.
We report twenty cases of acetabular fractures with... |
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SubjectTerms | Acetabular Acetábulo Fracturas Fractures Impresión Placas Planificación Planning Plates Preoperative Preparatorio Printing |
Title | 3D printing utility for surgical treatment of acetabular fractures |
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