Background:Old pelvis fractures are among the most challenging fractures to treat because of their complex anatomy,difficult-to-access surgical sites,and the relatively low incidence of such cases.Proper evaluation a...Background:Old pelvis fractures are among the most challenging fractures to treat because of their complex anatomy,difficult-to-access surgical sites,and the relatively low incidence of such cases.Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture.The goal of this study was to assess the use of three-dimensional (3D) printing techniques for surgical management of old pelvic fractures.Methods:First,16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data.Next,nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models.The pelvic injuries were all type C,and the average time from injury to reconstruction was 11 weeks (range:8-17 weeks).The workflow consisted of.:(1) Printing patient-specific bone models based on preoperative computed tomography (CT) scans,(2) virtual fracture reduction using the printed 3D anatomic template,(3) virtual fracture fixation using Kirschner wires,and (4) preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation.These models aided communication between surgical team members during the procedure.This technique was validated by comparing the preoperative planning to the intraoperative procedure.Results:The accuracy of the 3D printed models was within specification.Production of a model from standard CT DICOM data took 7 hours (range:6-9 hours).Preoperative planning using the 3D printed models was feasible in all cases.Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases.The patients were followed for 3-29 months (median:5 months).The fracture healing time was 9-17 weeks (mean:l0 weeks).No delayed incision healing,wound infection,or nonunions occurred.The results were excellent in two cases,g展开更多
基金This study was supported by grants from the National Natural Science Foundation of China,the Beijing Municipal Committee of Science and Technology
文摘Background:Old pelvis fractures are among the most challenging fractures to treat because of their complex anatomy,difficult-to-access surgical sites,and the relatively low incidence of such cases.Proper evaluation and surgical planning are necessary to achieve the pelvic ring symmetry and stable fixation of the fracture.The goal of this study was to assess the use of three-dimensional (3D) printing techniques for surgical management of old pelvic fractures.Methods:First,16 dried human cadaveric pelvises were used to confirm the anatomical accuracy of the 3D models printed based on radiographic data.Next,nine clinical cases between January 2009 and April 2013 were used to evaluate the surgical reconstruction based on the 3D printed models.The pelvic injuries were all type C,and the average time from injury to reconstruction was 11 weeks (range:8-17 weeks).The workflow consisted of.:(1) Printing patient-specific bone models based on preoperative computed tomography (CT) scans,(2) virtual fracture reduction using the printed 3D anatomic template,(3) virtual fracture fixation using Kirschner wires,and (4) preoperatively measuring the osteotomy and implant position relative to landmarks using the virtually defined deformation.These models aided communication between surgical team members during the procedure.This technique was validated by comparing the preoperative planning to the intraoperative procedure.Results:The accuracy of the 3D printed models was within specification.Production of a model from standard CT DICOM data took 7 hours (range:6-9 hours).Preoperative planning using the 3D printed models was feasible in all cases.Good correlation was found between the preoperative planning and postoperative follow-up X-ray in all nine cases.The patients were followed for 3-29 months (median:5 months).The fracture healing time was 9-17 weeks (mean:l0 weeks).No delayed incision healing,wound infection,or nonunions occurred.The results were excellent in two cases,g