DIGITAL DESIGN OF STANDARD PARTS DATABASE FOR PROXIMAL TIBIA FRACTURES TREATED WITH PLATING VIA THREE-DIMENSIONAL PRINTING_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

 CHENXuanhuang ¹ , ZHANGGuodong ^1,2 , LINHaibin ¹ , LUJianjun ³ , HUANGWenhua ² , YUZhengxi ¹ , CHENXu ¹ , WUXianwei ¹ , WUChangfu ¹

1. Department of Orthopedics, Teaching Hospital of Fujian Medical University, Affiliated Putian Hospital of Southern Medical University, Affiliated Hospital of Putian University, Putian Fujian, 351100, P. R. China;
2. Department of Human Anatomy, School of Basic Medical Sciences, Southern Medical University;
3. Department of Orthopedics, the Eighth Affiliated Hospital of Guangxi Medical University, the People's Hospital of Guigang City;

Corresponding author：

CHENXuanhuang, Email: ptyygk@163.com

Keywords：

Proximal tibia fracture; Internal fixation; Digital design; Three-dimensional printing; Standard parts

DOI：

10.7507/1002-1892.20150152

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To explore the method and feasibility of digital internal fixation for proximal tibia fractures using standard parts database and three-dimensional (3D) printing technology. Methods Ten adult lower extremity specimens were selected to take continuously thin-layer scanning. After Dicom image was imported into the Mimics software, the model of Schatzker Ⅱ-VI types proximal tibia fracture was established, 2 cases each type. The virtual internal fixation was performed with plate and screw from standard parts database. The pilot hole of the navigation module design was printed by 3D printing technique. The plate and screw were inserted by the navigation module. X-ray film and CT were taken postoperatively to observe the position. Thirty patients with proximal tibia fracture underwent digital internal fixation using standard parts database and 3D printing technology (study group), and another 30 patients underwent traditional open reduction and internal fixation (control group). There was no significant difference in sex, age, side, causes, fracture classification, associated injury, and course of disease between 2 groups (P>0.05). The preparative time, incision length, fracture healing time, operation time, and intraoperative blood loss were recorded. Follow up of imaging evaluation, clinical efficacy was evaluated by MacNab criteria. Results The navigation models were designed to fit the bony structure of proximal tibia and to guide implant insertion. The parameters of orientation, length, diameter, and angle were consistent with the preoperative plan. No statistically significant difference was found in the preparative times of pre-operation between 2 groups (t=1.393, P=0.169). The incision length, wound healing time, blood loss, operation time, and the cost of treatment in study group were significantly less than those in control group (P<0.05). All patients were followed up 12-16 months (mean, 13.5 months). The fracture healing time of study group was significantly shorter than that of control group (t=4.070, P=0.000). At 12 months postoperatively, there was no significant difference in the efficacy based on MacNab criteria between 2 groups (U=377.000, P=0.238). Conclusion Digital internal fixation for proximal tibia fractures using standard parts database and 3D printing technology has the advantages of short process, less blood loss, high safety and rapid fracture healing.

Citation： CHENXuanhuang, ZHANGGuodong, LINHaibin, LUJianjun, HUANGWenhua, YUZhengxi, CHENXu, WUXianwei, WUChangfu. DIGITAL DESIGN OF STANDARD PARTS DATABASE FOR PROXIMAL TIBIA FRACTURES TREATED WITH PLATING VIA THREE-DIMENSIONAL PRINTING. Chinese Journal of Reparative and Reconstructive Surgery, 2015, 29(6): 704-711. doi: 10.7507/1002-1892.20150152 Copy

1.	邱贵兴, 戴尅戎. 骨科手术学. 3版. 北京:人民卫生出版社, 2007:347.
2.	Papagelopoulos PJ, Partsinevelos AA, Themistocleous GS, et al. Complications after tibia plateau fracture surgery. Injury, 2006, 37(6):475-484.
3.	Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968-1975. Clin Orthop Relat Res, 1979, (138):94-104.
4.	Perren SM. The technology of minimally invasive percutaneous osteosynthesis (MIPO). Injury, 2002, 33 Suppl 1:VI-VⅡ.
5.	MacNab I. Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients. J Bone Joint Surg (Am), 1971, 53(5):891-903.
6.	Gösling T, Klingler K, Geerling J, et al. Improved intra-operative reduction control using a three-dimensional mobile image intensifier-a proximal tibia cadaver study. Knee, 2009, 16(1):58-63.
7.	Taylor J, Langenbach A, Marcellin-Little DJ. Risk factors for fibular fracture after TPLO. Vet Surg, 2011, 40(6):687-693.
8.	Khoury A, Liebergall M, Weil Y, et al. Computerized fluoroscopic-based navigation-assisted intramedullary nailing. Am J Orthop (Belle Mead NJ), 2007, 36(11):582-585.
9.	Hu Y, Li H, Qiao G, et al. Computer-assisted virtual surgical procedure for acetabular fractures based on real CT data. Injury, 2011, 42(10):1121-1124.
10.	Hu YL, Ye FG, Ji AY, et al. Three-dimensional computed tomography imaging increases the reliability of classification systems for tibial plateau fractures. Injury, 2009, 40(12):1282-1285.
11.	Messmer P, Long G, Suhm N, et al. Three-dimensional fracture simulation for preoperative planning and education. Eur J Trauma, 2001, 27(4):171-177.
12.	Osti M, Philipp H, Meusburger B, et al. Analysis of failure following anterior screw fixation of Type Ⅱ odontoid fractures in geriatric patients. Eur Spine J, 2011, 20(11):1915-1920.
13.	Shen F, Chen B, Guo Q, et al. Augmented reality patient-specific reconstruction plate design for pelvic and acetabular fracture surgery. Int J Comput Assist Radiol Surg, 2013, 8(2):169-179.
14.	Giannatsis J, Dedoussis V. Additive fabrication technologies applied to medicine and health care:a review. Int J Adv Manuf Technol, 2009, 40(1):116-127.
15.	Brown GA, Firoozabakhsh K, DeCoster TA, et al. Rapid prototyping:the future of trauma surgery? J Bone Joint Surg (Am), 2003, 85-A Suppl 4:49-55.
16.	Paiva WS, Amorim R, Bezerra DA, et al. Aplication of the stereoli-thography technique in complex spine surgery. Arq Neuropsiquiatr, 2007, 65(2B):443-445.
17.	Doornberg JN, Rademakers MV, van den Bekerom MP, et al. Two-dimensional and three-dimensional computed tomography for the classification and characterisation of tibial plateau fractures. Injury, 2011, 42(12):1416-1425.
18.	Wu ZX, Huang LY, Sang HX, et al. Accuracy and safety assessment of pedicle screw placement using the rapid prototypingtechnique in severe congenital scoliosis. Spinal Disord Tech, 2011, 24(7):444-450.
19.	Uehara M, Takahashi J, Hirabayashi H, et al. Computer-assisted C1-C2 Transarticular Screw Fixation "Magerl Technique" for Atlantoaxial Instability. Asian Spine J, 2012, 6(3):168-177.
20.	Xie A, Fang C, Huang Y, et al. Application of three-dimensional reconstruction and visible simulation technique in reoperation of hepatolithiasis. J Gastroenterol Hepatol, 2013, 28(2):248-254.
21.	Bagaria V, Deshpande S, Rasalkar DD, et al. Use of rapid prototyping and three-dimensional reconstruction modeling in the management of complex fractures. Eur J Radiol, 2011, 80(3):814-820.
22.	Tricot M, Duy KT, Docquier PL. 3D-corrective osteotomy using surgical guides for posttraumatic distal humeral deformity. Acta Orthop Belg, 2012, 78(4):538-542.

1. 邱贵兴, 戴尅戎. 骨科手术学. 3版. 北京:人民卫生出版社, 2007:347.
2. Papagelopoulos PJ, Partsinevelos AA, Themistocleous GS, et al. Complications after tibia plateau fracture surgery. Injury, 2006, 37(6):475-484.
3. Schatzker J, McBroom R, Bruce D. The tibial plateau fracture. The Toronto experience 1968-1975. Clin Orthop Relat Res, 1979, (138):94-104.
4. Perren SM. The technology of minimally invasive percutaneous osteosynthesis (MIPO). Injury, 2002, 33 Suppl 1:VI-VⅡ.
5. MacNab I. Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients. J Bone Joint Surg (Am), 1971, 53(5):891-903.
6. Gösling T, Klingler K, Geerling J, et al. Improved intra-operative reduction control using a three-dimensional mobile image intensifier-a proximal tibia cadaver study. Knee, 2009, 16(1):58-63.
7. Taylor J, Langenbach A, Marcellin-Little DJ. Risk factors for fibular fracture after TPLO. Vet Surg, 2011, 40(6):687-693.
8. Khoury A, Liebergall M, Weil Y, et al. Computerized fluoroscopic-based navigation-assisted intramedullary nailing. Am J Orthop (Belle Mead NJ), 2007, 36(11):582-585.
9. Hu Y, Li H, Qiao G, et al. Computer-assisted virtual surgical procedure for acetabular fractures based on real CT data. Injury, 2011, 42(10):1121-1124.
10. Hu YL, Ye FG, Ji AY, et al. Three-dimensional computed tomography imaging increases the reliability of classification systems for tibial plateau fractures. Injury, 2009, 40(12):1282-1285.
11. Messmer P, Long G, Suhm N, et al. Three-dimensional fracture simulation for preoperative planning and education. Eur J Trauma, 2001, 27(4):171-177.
12. Osti M, Philipp H, Meusburger B, et al. Analysis of failure following anterior screw fixation of Type Ⅱ odontoid fractures in geriatric patients. Eur Spine J, 2011, 20(11):1915-1920.
13. Shen F, Chen B, Guo Q, et al. Augmented reality patient-specific reconstruction plate design for pelvic and acetabular fracture surgery. Int J Comput Assist Radiol Surg, 2013, 8(2):169-179.
14. Giannatsis J, Dedoussis V. Additive fabrication technologies applied to medicine and health care:a review. Int J Adv Manuf Technol, 2009, 40(1):116-127.
15. Brown GA, Firoozabakhsh K, DeCoster TA, et al. Rapid prototyping:the future of trauma surgery? J Bone Joint Surg (Am), 2003, 85-A Suppl 4:49-55.
16. Paiva WS, Amorim R, Bezerra DA, et al. Aplication of the stereoli-thography technique in complex spine surgery. Arq Neuropsiquiatr, 2007, 65(2B):443-445.
17. Doornberg JN, Rademakers MV, van den Bekerom MP, et al. Two-dimensional and three-dimensional computed tomography for the classification and characterisation of tibial plateau fractures. Injury, 2011, 42(12):1416-1425.
18. Wu ZX, Huang LY, Sang HX, et al. Accuracy and safety assessment of pedicle screw placement using the rapid prototypingtechnique in severe congenital scoliosis. Spinal Disord Tech, 2011, 24(7):444-450.
19. Uehara M, Takahashi J, Hirabayashi H, et al. Computer-assisted C1-C2 Transarticular Screw Fixation "Magerl Technique" for Atlantoaxial Instability. Asian Spine J, 2012, 6(3):168-177.
20. Xie A, Fang C, Huang Y, et al. Application of three-dimensional reconstruction and visible simulation technique in reoperation of hepatolithiasis. J Gastroenterol Hepatol, 2013, 28(2):248-254.
21. Bagaria V, Deshpande S, Rasalkar DD, et al. Use of rapid prototyping and three-dimensional reconstruction modeling in the management of complex fractures. Eur J Radiol, 2011, 80(3):814-820.
22. Tricot M, Duy KT, Docquier PL. 3D-corrective osteotomy using surgical guides for posttraumatic distal humeral deformity. Acta Orthop Belg, 2012, 78(4):538-542.

Chinese Journal of Reparative and Reconstructive Surgery

DIGITAL DESIGN OF STANDARD PARTS DATABASE FOR PROXIMAL TIBIA FRACTURES TREATED WITH PLATING VIA THREE-DIMENSIONAL PRINTING

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content