Researchers decide 3D printing more practical in treating hip fractures

A gaggle of researchers from China and the U.S. have used 3D printing to create 1:1 scale pelvic fashions of hip fracture sufferers, to assist within the surgical therapy of both-column acetabular fractures.

Within the examine, the researchers evaluate conventional strategies of contouring plates intra-operatively with the usage of pre-contoured plates in accordance with bodily 3D printed pelvic fashions. The paper presents the usage of each 3D printing and digital simulation in pre-operative planning for both-column acetabular fractures. 

In the end, the researchers hypothesize that 3D printing can help orthopedic surgeons in shortening the time and bettering the medical outcomes of the surgical process.

The 3D models of the fracture fragments. Image via Chinese Medical Journal.The 3D fashions of the fracture fragments. Picture through Chinese language Medical Journal.

The advantages of 3D printing in surgical procedures

An acetabular fracture is a break within the socket portion of the “ball-and-socket” hip joint. Each-column acetabular fractures confer with when your complete weight-bearing articular floor is indifferent from the sacroiliac joint. They’re probably the most severe and the second commonest kind of acetabular fractures, the researchers clarify. In accordance with the paper, “roughly 21 p.c of all acetabular fractures involving each columns of the acetabulum require good discount and secure inner fixation to stop post-traumatic arthritis and procure glorious medical outcomes.”

Nonetheless, surgical therapy of both-column acetabular fractures have proved difficult due to the advanced acetabular fracture patterns and curved floor of the acetabulum. Conventional operations for acetabular fractures are restricted to a small variety of anterior approaches, and require contouring of the plates mid-surgery, which will increase the operation time in addition to blood loss. 

The researchers establish 3D printing expertise as a possible route for serving to surgeons perceive the form of the fracture fragments and simulate the discount of the fracture, particularly in advanced acetabular fractures. “Three-dimensional (3D) printing expertise is creating quickly and is broadly utilized in medical functions as a result of it’s simply accessible by way of the tools and value,” the authors add.

3D printing might help surgical procedures for both-column acetabular fractures through pre-operative digital simulations with 3D printed, 1:1 scaled pelvic fashions for pre-contouring of the plates. Explaining the advantages and limitations of this course of, the researchers state that “Prior research have revealed that the applying of 3D printing expertise within the surgical therapy of acetabular fractures can considerably scale back the operation time and blood loss however can not get hold of a fracture discount of considerably higher high quality.” 

The researchers consider that, with 3D printing expertise, orthopedic surgeons will be capable to shorten operation time whereas bettering the medical outcomes, such because the post-operative fracture discount high quality, hip joint perform, and complication price.

Certainly, 3D printing has beforehand seen profitable functions in numerous forms of hip surgical procedures. In late 2019,  LOGEEKs Medical Methods (MS), revealed that its 3D printed implants had been utilized in a reconstructive restoration surgical procedure of the hip joint, along with impaction bone grafting. Within the yr previous to that, Florida surgeons additionally carried out a hip substitute surgical procedure utilizing 3D printed implants from ConforMIS, a medical expertise firm primarily based in Massachusetts. 

The result of surgery, showing the 3D printed implant. Image via LOGEEKs.The results of surgical procedure, exhibiting the 3D printed implant. Picture through LOGEEKs.

3D printing more practical in treating hip fractures

To hold out their analysis, the group established a randomized potential case–management examine of 40 sufferers recognized with both-column acetabular fractures between September 2013 and September 2017. Twenty sufferers have been allotted to the 3D printing group, and the opposite 20 sufferers have been allotted to the traditional methodology group utilizing block randomization.

The tactic for digital simulation and 3D printing fashions of fracture fragments concerned saving topography pictures of every affected person’s pelvis as Digital Imaging and Communication in Medication (DICOM) recordsdata. These have been then imported into MIMICS, the medical 3D picture processing software program developed by Materialise. The fracture fragments have been decreased anatomically utilizing the reposition perform, after which exported as STL recordsdata and imported into Materialise Magics software program for fixing and assist era. 

Images of one case in the 3D printing group. Image via Chinese Medical Journal.Photographs of 1 case within the 3D printing group. Picture through Chinese language Medical Journal.

The ultimate STL was then 3D printed and used to pre-contour the plates for surgical process, with the size of the screws measured utilizing the 3D printed decreased hemi-pelvis mannequin. After the surgical simulation, the pre-contoured anatomic plates and screws have been disinfected and used to assist the acetabular surgical procedures. 

From evaluating the outcomes, the researchers noticed digital simulation and 3D printing as a more practical methodology than typical strategies for treating both-column acetabular fractures: “We discovered that the post-operative fracture discount high quality and the hip joint perform within the 3D printing group have been considerably higher than these within the typical methodology group […] The 3D printed decreased hemi-pelvis fashions could assist in anatomically pre-contouring the plates to acquire good fracture discount high quality and hip joint perform and scale back the danger of traumatic arthritis […]  The operation time, the instrumentation time, and the time of intra-operative fluoroscopy have been considerably shorter, and the blood loss and blood transfusion have been considerably much less within the 3D printing group than within the typical methodology group.”

The paper, “Surgical therapy for both-column acetabular fractures utilizing pre-operative digital simulation and three-dimensional printing strategies,” is printed in Chinese language Medical Journal. It’s written by Huang JH, Liao H, Tan XY, Xing WR, Zhou Q, Zheng YS, Cao HY and Zeng CJ. 

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Featured picture exhibits the 3D fashions of the fracture fragments. Picture through Chinese language Medical Journal.

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