Efficacy of 3D printed personalised infra-acetabular screw guides in the treatment of acetabular fractures
Objective To investigate the efficacy and safety of 3D printed personalized in vivo guide assisted infra-acetabular screws placement in the treatment of acetabular fracture.Methods The clinical data of patients with acetabular fracture treated with in-fra-acetabular screws in the Department of Orthopaedics,Affiliated Hospital of Traditional Chinese Medicine,Xinjiang Medical Uni-versity from January 2020 to December 2022 were analyzed retrospectively.They were divided into two groups according to whether 3D printed personalized infra-acetabular screws guides were used or not:18 patients in the free-hand screw placement group,including 16 males and 2 females,with an average age of 46.61±13.82 years.There were 2 anterior column fractures,5 anterior column with pos-terior hemitransverse fractures,2 T-type fractures,and 9 bicolumnar fractures.There were 20 patients in the guide group,including 17 males and 3 females,with a mean age of 41.80±16.75 years.There were 2 anterior column fractures,6 anterior column with posterior hemitransverse fractures,2 T-type fractures,and 10 bicolumnar fractures.The operation time,blood loss,cumulative fluoroscopy times,fracture reduction quality,functional evaluation results and complications were recorded and compared between the two groups.Re-sults 38 patients were followed up for 11-27 months,with an average of 18.1 months.The operation time of 192.00±40.44 min,intraop-erative blood loss of 818.33±191.38ml and fluoroscopy times of 11.33±1.68 times in free-hand screw placement group were signifi-cantly more than 165.00±29.48 min,667.50±201.88ml and 8.70±2.03 times in guide plate group,and the differences had statistical significance(P<0.05).There was no significant difference in postoperative Matta score,postoperative Matta score at 3 months and Merled'Aubigne-Postel score at the last follow-up between the two groups(P>0.05).In the free-hand screw placement group,there were 2 cases of lateral femoral cutaneous nerve injury,1 case of incision infection and 1 case of traumatic arthritis after operation.In the guide plate group,there was 1 case of lateral femoral cutaneous nerve injury and 1 case of incision infection.The difference in the inci-dence rate of complications between the two groups had no statistical significance(P>0.05).Conclusion 3D printing personalized in-fra-acetabular screws guide assisted screw placement can reduce the number of intraoperative fluoroscopy,shorten the operation time,reduce intraoperative blood loss,and the clinical efficacy is satisfactory.
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