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Improved accuracy of 3D-printed navigational template during complicated tibial plateau fracture surgery

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Abstract

This study was aimed to improve the surgical accuracy of plating and screwing for complicated tibial plateau fracture assisted by 3D implants library and 3D-printed navigational template. Clinical cases were performed whereby complicated tibial plateau fractures were imaged using computed tomography and reconstructed into 3D fracture prototypes. The preoperative planning of anatomic matching plate with appropriate screw trajectories was performed with the help of the library of 3D models of implants. According to the optimal planning, patient-specific navigational templates produced by 3D printer were used to accurately guide the real surgical implantation. The fixation outcomes in term of the deviations of screw placement between preoperative and postoperative screw trajectories were measured and compared, including the screw lengths, entry point locations and screw directions. With virtual preoperative planning, we have achieved optimal and accurate fixation outcomes in the real clinical surgeries. The deviations of screw length was 1.57 ± 5.77 mm, P > 0.05. The displacements of the entry points in the x-, y-, and z-axis were 0.23 ± 0.62, 0.83 ± 1.91, and 0.46 ± 0.67 mm, respectively, P > 0.05. The deviations of projection angle in the coronal (x–y) and transverse (x–z) planes were 6.34 ± 3.42° and 4.68 ± 3.94°, respectively, P > 0.05. There was no significant difference in the deviations of screw length, entry point and projection angle between the ideal and real screw trajectories. The ideal and accurate preoperative planning of plating and screwing can be achieved in the real surgery assisted by the 3D models library of implants and the patient-specific navigational template. This technology improves the accuracy and efficiency of personalized internal fixation surgery and we have proved this in our clinical applications.

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References

  1. Kamineni S (2002) Tibial plateau fracture. Orthopedics 25(8):858–859

    PubMed  Google Scholar 

  2. Luo CF, Sun H, Zhang B, Zeng BF (2010) Three-column fixation for complex tibial plateau fractures. J Orthop Trauma 24(11):683–692. doi:10.1097/BOT.0b013e3181d436f3

    Article  PubMed  Google Scholar 

  3. Persiani P, Gurzi MD, Di Domenica M, Rosi S, Attala D, Villani C (2013) Risk analysis in tibial plateau fractures: association between severity, treatment and clinical outcome. Musculoskelet Surg 97(2):131–136. doi:10.1007/s12306-012-0237-9

    Article  PubMed  Google Scholar 

  4. Lin S, Mauffrey C, Hammerberg EM, Stahel PF, Hak DJ (2014) Surgical site infection after open reduction and internal fixation of tibial plateau fractures. Eur J Orthop Surg Traumatol 24(5):797–803. doi:10.1007/s00590-013-1252-8

    Article  PubMed  Google Scholar 

  5. Lee MH, Hsu CJ, Lin KC, Renn JH (2014) Comparison of outcome of unilateral locking plate and dual plating in the treatment of bicondylar tibial plateau fractures. J Orthop Surg Res 9:62. doi:10.1186/s13018-014-0062-y

    Article  PubMed Central  PubMed  Google Scholar 

  6. Timmers TK, van der Ven DJ, de Vries LS, van Olden GD (2014) Functional outcome after tibial plateau fracture osteosynthesis: a mean follow-up of 6years. Knee 21(6):1210–1215. doi:10.1016/j.knee.2014.09.011

    Article  PubMed  Google Scholar 

  7. Tahririan MA, Mousavitadi SH, Derakhshan M (2014) Comparison of functional outcomes of tibial plateau fractures treated with nonlocking and locking plate fixations: a nonrandomized clinical trial. ISRN Orthop 2014:324573. doi:10.1155/2014/324573

    Article  PubMed Central  PubMed  Google Scholar 

  8. Biggi F, Di Fabio S, D’Antimo C, Trevisani S (2010) Tibial plateau fractures: internal fixation with locking plates and the MIPO technique. Injury 41(11):1178–1182. doi:10.1016/j.injury.2010.08.001

    Article  CAS  PubMed  Google Scholar 

  9. Kwon SY, Kim Y, Ahn HW, Kim KB, Chung KR, Kim Sunny SH (2014) Computer-aided designing and manufacturing of lingual fixed orthodontic appliance using 2D/3D registration software and rapid prototyping. Int J Dent 2014:164164. doi:10.1155/2014/164164

    Article  PubMed Central  PubMed  Google Scholar 

  10. Merc M, Drstvensek I, Vogrin M, Brajlih T, Friedrich T, Recnik G (2014) Error rate of multi-level rapid prototyping trajectories for pedicle screw placement in lumbar and sacral spine. Chin J Traumatol 17(5):261–266

    PubMed  Google Scholar 

  11. Park JM, Tatad JC, Landayan ME, Heo SJ, Kim SJ (2014) Optimizing third molar autotransplantation: applications of reverse-engineered surgical templates and rapid prototyping of three-dimensional teeth. J Oral Maxillofac Surg 72(9):1653–1659. doi:10.1016/j.joms.2014.04.012

    Article  PubMed  Google Scholar 

  12. Yin Q, Liu W, Wang S (2014) Application of customized augments fabricated by rapid prototyping for severe bone defects of the knee. Chin Med J 127(15):2870–2871

    PubMed  Google Scholar 

  13. Müller ME, Allgöwer M, Schneider R, Willenegger R (1991) AO manual of internal fixation, 3rd edn. Springer, Berlin

    Book  Google Scholar 

  14. Thomas C, Athanasiov A, Wullschleger M, Schuetz M (2009) Current concepts in tibial plateau fractures. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca 76(5):363–373

    PubMed  Google Scholar 

  15. Berkson EM, Virkus WW (2006) High-energy tibial plateau fractures. J Am Acad Orthop Surg 14(1):20–31

    PubMed  Google Scholar 

  16. Beger HG (2010) 150 years Langenbeck’s Archives–from case-based to evidence-based to personalized surgery. Langenbeck’s archives of surgery/Deutsche Gesellschaft fur Chirurgie 395(4):293–294. doi:10.1007/s00423-010-0614-5

    Article  PubMed  Google Scholar 

  17. Imran Hamid U, Digney R, Soo L, Leung S, Graham AN (2014) Incidence and outcome of re-entry injury in redo cardiac surgery: benefits of preoperative planning. Eur J Cardio-thorac Surg. doi:10.1093/ejcts/ezu261

    Google Scholar 

  18. Xiang L, Zhou Y, Wang H, Zhang H, Song G, Zhao Y, Han J, Liu J (2014) Significance of preoperative planning simulator for junior surgeons’ training of pedicle screw insertion. J Spin disord Tech. doi:10.1097/bsd.0000000000000138

    Google Scholar 

  19. Linkevicius T, Puisys A, Linkeviciene L, Peciuliene V, Schlee M (2013) Crestal bone stability around implants with horizontally matching connection after soft tissue thickening: a prospective clinical trial. Clin Implant Dent Relat Res. doi:10.1111/cid.12155

    Google Scholar 

  20. Nakamura H, Yamaguchi H, Takagaki M, Kadowaki T, Nakao T, Amano A (2014) Rigorous patient-prosthesis matching of Perimount Magna aortic bioprosthesis. Asian Cardiovasc Thorac Ann. doi:10.1177/0218492314543654

    Google Scholar 

  21. Canullo L, Iannello G, Gotz W (2011) The influence of individual bone patterns on peri-implant bone loss: preliminary report from a 3-year randomized clinical and histologic trial in patients treated with implants restored with matching-diameter abutments or the platform-switching concept. Int J Oral Maxillofac Implants 26(3):618–630

    PubMed  Google Scholar 

  22. Wong KKL, Tu JY, Sun Z, Dissanayake DW (2013) Methods in research and development of biomedical devices. World Scientific Publishing Co., Singapore. ISBN 978-981-4434-99-7

    Book  Google Scholar 

  23. Prasad GT, Kumar TS, Kumar RK, Murthy GK, Sundaram N (2013) Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates. Indian J Orthop 47(2):188–194. doi:10.4103/0019-5413.108915

    Article  PubMed Central  PubMed  Google Scholar 

  24. Gosling T, Schandelmaier P, Muller M, Hankemeier S, Wagner M, Krettek C (2005) Single lateral locked screw plating of bicondylar tibial plateau fractures. Clin Orthop Relat Res 439:207–214

    Article  CAS  PubMed  Google Scholar 

  25. Uehara M, Takahashi J, Hirabayashi H, Hashidate H, Ogihara N, Mukaiyama K, Kato H (2012) Computer-assisted C1-C2 transarticular screw fixation “Magerl Technique” for atlantoaxial instability. Asian Spine J 6(3):168–177. doi:10.4184/asj.2012.6.3.168

    Article  PubMed Central  PubMed  Google Scholar 

  26. Hu Y, Li H, Qiao G, Liu H, Ji A, Ye F (2011) Computer-assisted virtual surgical procedure for acetabular fractures based on real CT data. Injury 42(10):1121–1124. doi:10.1016/j.injury.2011.01.014

    Article  PubMed  Google Scholar 

  27. Cartiaux O, Paul L, Francq BG, Banse X, Docquier PL (2014) Improved accuracy with 3D planning and patient-specific instruments during simulated pelvic bone tumor surgery. Ann Biomed Eng 42(1):205–213. doi:10.1007/s10439-013-0890-7

    Article  PubMed  Google Scholar 

  28. Fornaro J, Keel M, Harders M, Marincek B, Szekely G, Frauenfelder T (2010) An interactive surgical planning tool for acetabular fractures: initial results. J Orthop Surg Res 5:50. doi:10.1186/1749-799X-5-50

    Article  PubMed Central  PubMed  Google Scholar 

  29. Hu Y, Yuan ZS, Spiker WR, Albert TJ, Dong WX, Xie H, Yuan JB, Wang CT (2013) Deviation analysis of C2 translaminar screw placement assisted by a novel rapid prototyping drill template: a cadaveric study. Eur Spine J 22(12):2770–2776. doi:10.1007/s00586-013-2993-0

    Article  PubMed Central  PubMed  Google Scholar 

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Acknowledgments

This work is supported in part by the 863 Program of China under Grant 2012AA02A603, and in part by the Guangzhou science and technology planning Project under Grant 2014J4100153.

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Authors and Affiliations

  1. Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Sciences, Southern Medical University, North-1838, Guangzhou, 510515, China

    Huajun Huang, Guodong Zhang, Hanbin Ouyang, Bin Yan, Jing Xu, Yang Yang, Zhanglin Wu & Wenhua Huang

  2. Department of Biomedical Engineering, Chung Yuan Christian University, 200 Chung Pei Road, Chung Li District, Taoyuan City, 32023, Taiwan

    Ming-Fa Hsieh

  3. The Third Affiliated Hospital of Southern Medical University, Academy of Orthopedics of Guangdong Province, Guangzhou, 510630, China

    Canjun Zeng

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  1. Huajun Huang
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  10. Wenhua Huang
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Correspondence to Wenhua Huang.

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Huang, H., Hsieh, MF., Zhang, G. et al. Improved accuracy of 3D-printed navigational template during complicated tibial plateau fracture surgery. Australas Phys Eng Sci Med 38, 109–117 (2015). https://doi.org/10.1007/s13246-015-0330-0

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  • DOI: https://doi.org/10.1007/s13246-015-0330-0

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