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Evaluation of accuracy of virtual surgical planning for patient-specific pre-contoured plate in acetabular fracture fixation

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Acetabular fractures are amongst the most challenging fractures to treat because of complex anatomy. Open reduction and internal fixation remains the standard treatment for displaced acetabular fractures to achieve anatomical reduction as in any other intra-articular fracture. Patient-specific pre-contoured reconstruction plate template made by a pre-operative virtual surgical planning can be useful to respect patient’s morphology, reduce surgical invasiveness and simplify the surgical procedure. Proper evaluation and surgical planning is necessary to achieve these goals. The goal of this study was to evaluate the outcomes of using virtual surgical planning and virtually pre-contoured plate template in comparison with the conventional method of intra-operative contouring of reconstruction plate for acetabular fracture fixation.

Methods

Twenty-five patients were categorized into group A and B by computerized randomization. In group A (12 patients), CT-based virtual surgical planning was done using Mimics and 3-Matic software to form virtually pre-contoured plates, which were 3D printed to act as templates over which 3.5 mm reconstruction plates were manually contoured pre-operatively and used for fixation. In group B (13 patient), conventional method of intra-operative contouring to adapt the plate to the fracture region was followed. Blood loss, surgical time, reduction on X-rays and post-operative computed tomography were compared between two groups.

Results

Duration of surgery and total blood loss were found to be less while reduction was found to satisfactory/anatomical in higher percentage of Group A than Group B patients.

Conclusions

Virtual surgical planning, patient-specific virtually pre-contoured plate template and 3D printing technology improve the outcomes of acetabular fracture surgery by reducing duration and invasiveness of surgery and improving the quality of reduction. However, studies with larger sample size are required to further validate it.

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Abbreviations

NCCT:

Non-contrast computed tomography

3D:

Three-dimensional

DICOM:

Digital imaging and communications in medicine

CAD:

Computer-aided design

RP:

Rapid prototyping

PLA:

Poly-lactic acid

CNC:

Computer numerical control

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Funding

This study has not received any funds/grants from any individual or organization.

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Authors and Affiliations

  1. Department of Orthopaedics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India

    Lalit Maini, Tarun Verma, Amit Sharma, Ankur Sharma & Abhishek Mishra

  2. Department of Mechanical Engineering, Indian Institute of Technology, New Delhi, India

    Sunil Jha

  3. C-40, Omkar Society, Maneja, Vadodara, Gujarat, 390013, India

    Tarun Verma

Authors
  1. Lalit Maini
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  2. Tarun Verma
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  3. Amit Sharma
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  4. Ankur Sharma
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  5. Abhishek Mishra
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  6. Sunil Jha
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Corresponding author

Correspondence to Tarun Verma.

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The authors have no conflict of interest.

Informed consent

Informed consent was obtained from every individual participants included in the study.

Ethical approval

Ethical clearance was taken from institute’s ethical committee prior to the study.

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Maini, L., Verma, T., Sharma, A. et al. Evaluation of accuracy of virtual surgical planning for patient-specific pre-contoured plate in acetabular fracture fixation. Arch Orthop Trauma Surg 138, 495–504 (2018). https://doi.org/10.1007/s00402-018-2868-2

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  • DOI: https://doi.org/10.1007/s00402-018-2868-2

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