Application of computer-assisted virtual surgical procedures and three-dimensional printing of patient-specific pre-contoured plates in bicolumnar acetabular fracture fixation

Introduction: With the rapid development of three-dimensional (3D) printing and computer technology, adopting computer-assisted virtual surgical procedures and 3D printing of patient-specific pre-contoured plates can greatly reduce surgical invasiveness and operative time and simplify the procedure. Hypothesis: Use of computer-assisted virtual surgical procedures and 3D printing of patient-specific pre-contoured plates reduce the operative time and blood loss in bicolumnar acetabular fracture fixation. Methods: A retrospective analysis was performed for 52 bicolumnar acetabular fracture cases treated surgically in our department from January 2013 to January 2017. According to the patients' willingness to accept 3D printing services, 52 patients were divided into groups A and B. In group A (28 patients), computer-assisted virtual surgical procedures and 3D printing of patient-specific pre-contoured plates were adopted. In group B (24 patients), the conventional method was adopted. Fracture type, operative blood loss, surgical time, complications, radiographic quality of reduction, and hip function were compared between groups. All patients were operated by the same surgeon. Results: The real surgical procedure of all patients in group A was almost identical to the preoperative virtual operation. Operative time and intraoperative blood loss were significantly reduced in group A than in group B (p < 0.05), while the postoperative fracture reduction quality and hip function obtained slightly higher levels of satisfaction in group A. Conclusions: Computer-assisted virtual surgical procedures, 3D printing technology and patient-specific pre-contoured plates can reduce the operative time and blood loss with less surgical invasiveness and ensure completely satisfactory clinical outcomes. However, promotion of this technology requires additional work. (C) 2019 Published by Elsevier Masson SAS.