Authors (including presenting author) :
Ng KM(1), Hui CLA(2), Ho KWK(3)
Affiliation :
(1) Prosthetic and Orthotic Department, United Christian Hospital
(2) Department of Orthopaedic & Traumatology, United Christian Hospital
(3) Department of Orthopaedics & Traumatology, The Chinese University of Hong Kong
Introduction :
In United Christian Hospital, 3D printing service has been established by the Prosthetic and Orthotic Department since 2018. 3D printed anatomical models, modified anatomical models and surgical instruments have been utilized gradually in Orthopaedic surgery. Models are used as a visualization tool of fracture morphology and surgical planning, including the selection of fixation instrument, simulation of surgical approach and pre-contouring of implant.
Objectives :
The objective of the present research was to evaluate the effectiveness of 3-dimensional (3D) printed anatomical models in surgical treatment for trimalleolar fracture.
Methodology :
A retrospective case cohort comparison was conducted. 40 patients who were admitted to United Christian Hospital between November 2019 and January 2021 with surgical treatment for trimalleolar fracture were selected. Patients were divided into 2 groups based on the application of anatomical model (3D printing group; n=14) or conventional treatment (conventional group; n=26). 3D printed anatomical model of fracture side and mirrored non-fracture side distal ankle were utilized for surgical planning, including fracture morphology visualization, surgical rehearsal and pre-contouring of implant, in 3D printing group. Early postoperative outcomes, including operation time, blood loss volume, fixation methods, drainage volume, quality of reduction (Teeny & Wiss Score), functional outcome (Olerud & Molander Score), total length of stay, preoperative length of stay, and complication rate were compared between groups.
Result & Outcome :
Characteristics between groups were comparable in terms of age, gender, injury mechanism, injury side, fracture type, and posterior malleolus fragment size. No significant difference in mean follow-up duration was found (5.62 ± 3.67 vs 4.64 ± 2.37 months). Significantly lower drainage volume (37.27 ± 34.96 vs 65.67 ± 33.75 ml; p=0.027), higher posterior malleolus fixation rate (85.7% vs 30.8%; p=0.003), higher “anatomic” reduction rate (71.4% vs 34.6%; p=0.026) and lower complication rate (0.0% vs 26.9%; p=0.035) were observed in 3D printing group.
Based on the data found, 3D printing group demonstrated higher posterior malleolus fixation rate, better reduction quality and lower complication rate. 3D printed anatomical model potentially led to more efficient surgical treatment for trimalleolar fracture.
