Combining 3D printing technology with customized metal plates for the treatment of complex acetabular fractures: A retrospective study

Abstract

Purposes The purpose of this study is to evaluate the clinical outcomes of combining 3D printing technology with customized metal plates in the treatment of complex acetabular fractures. Methods A retrospective study was conducted on 42 patients with complex acetabular fractures treated at our hospital between September 1, 2020 and May 31, 2022. The patients were divided into two groups: the conventional group and the 3D printing group, with 21 individuals in each group.The conventional group underwent surgery using traditional surgical techniques, with appropriate bending and adjustment of the metal plates during the procedure. In the 3D printing group, preoperative 3D printing technology was utilized to create a physical model of the fracture, and individualized metal plates were customized based on the model after virtual reduction. Comparison was made between the two groups of patients regarding surgical approach, operative time, instrument handling time, intraoperative blood loss, number of fluoroscopy scans, fracture healing time, quality of fracture reduction postoperatively, hip joint function at 12 months postoperatively, and occurrence of complications during the follow-up period. Results The 3D printing group showed significantly shorter surgical time (124.76±12.89 minutes vs. 174.05±12.51 minutes), instrument operation time (44.57±5.32 minutes vs. 62.9±7.47 minutes), intraoperative blood loss (337.38±51.95 mL vs. 545.24±74.39 mL), and intraoperative fluoroscopy frequency (8.25±1.18 times vs. 10.52±1.6 times) compared to the conventional group (P<0.001). The postoperative fracture reduction quality in the 3D printing group was good in 95.24% (20/21) of cases, significantly higher than the 61.90% (13/21) in the conventional group (P = 0.02). The excellent and good hip function rate in the 3D printing group was 90.48% (19/21), which was also significantly higher than 57.14% (12/21) in the conventional group (P = 0.01). No significant difference was observed between the two groups in fracture healing time (13.95±1.07 weeks vs. 13.81±1.17 weeks) and complication rate (9.52% vs. 28.57%) (P = 0.14; P = 0.24). Conclusion The application of 3D printing technology in conjunction with individualized customization of metal plates for the treatment of complex acetabular fractures can shorten surgical and instrument handling time, reduce intraoperative blood loss, and improve the quality of fracture reduction as well as the recovery of hip joint function.These results provide new insights and technical support for the treatment of complex acetabular fractures.