Surgical repair of distal femur fractures with 3D printed biomodels
Keywords:
3D printing, complex fractures, distal femur, operative planning.Abstract
Introduction: Complex distal femur fractures AO/AOT type 33C3.3 constitute a challenge for orthopedists due to the difficulty of their treatment and associated complications. The surgical planning and procedure use condylar plates; but these are associated with loss of fixation and collapse of the reduction.
Objective: To describe preoperative planning for an AO/AOT 33C3.3 distal femur fracture with 3D bioprinting and computer reconstruction.
Case report: The case of a 34-year-old male patient is reported. He has comminuted left fracture of the distal femur, AO/AOT type 33C3.3, due to a traffic accident. Surgical planning and treatment were successfully performed with 3D biomodel printing and reconstruction. Based on the patient's tomographic images, the main fragments, the reduction sequence, the number and position of the implants to be used were identified.
Conclusions: Preoperative planning is a critically important stage in managing complex fractures. Conventional techniques can be optimized with computer-assisted surgery and reconstruction with 3D printed biomodels. This novel proposal will allow the appropriate use of materials, optimal reduction sequence, better stability of the fracture and lower risk of surgical complications.
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References
Bagaria V, Bhansali R, Pawar P. 3D printing-creating a blueprint for the future of orthopedics: current concept review and the road ahead! J Clin Orthop Trauma. 2018;9(3):207-12. DOI: https://doi.org/10.1016%2Fj.jcot.2018.07.007
Imam M, Torieh A, Matthana A. Double plating of intra articular multifragmentary C3-type distal femoral fractures through the anterior approach. Eur J Orthop Surg Traumatol. 2018;28(1):121-30. DOI: https://doi.org/10.1007/s00590-017-2014-9
Baruah JP, Bora S, Medhi H, Haque A. The outcome following fixation of complex open distal femur fractures. Int J Orthop. 2019;5(4):297-301. DOI: http://dx.doi.org/10.22271/ortho.2019.v5.i4f.1688
Agrawal A, Kiyawat V. Complex AO type C3 distal femur fractures: Results after fixation with a lateral locked plate using modified swashbuckler approach. Indian J Orthop. 2017;51(1):18-27. DOI: https://doi.org/10.4103/0019-5413.197516
Jeong HS, Park KJ, Kil KM, Chong S, Eun HJ, Lee TS, et al. Minimally invasive plate osteosynthesis using 3D printing for shaft fractures of clavicles: technical note. Arch Orthop Trauma Surg. 2014;134(11):1551-5. DOI: https://doi.org/10.1007/s00402-014-2075-8
Saka N, Watanabe Y, Sasaki G, Kawano H. Corrective intra-articular osteotomy using a 3D-printed model and induced membrane technique for AO/OTA C3 distal femur fracture with articular malunion and metaphyseal nonunion. Case Rep Orthop. 2020;2020:1250231. DOI: https://doi.org/10.1155/2020/1250231
Downey C, Leonard M, McCarrick C, Fenelon C, Murphy E, O’Daly B. A novel approach using 3-D printing in the Irish National Centre for pelvic and acetabular surgery. Ir J Med Sci. 2020;189(1):219-28. DOI: https://doi.org/10.1007/s11845-019-02055-y
Chen K, Yang F, Yao S, Xiong Z, Sun T, Zhu F, et al. Application of computer-assisted virtual surgical procedures and three-dimensional printing of patient-specific pre-contoured plates in bicolumnar acetabular fracture fixation. Orthop Traumatol Surg Res. 2019;105(5):877-84. DOI: https://doi.org/10.1016/j.otsr.2019.05.011
Huang H, Hsieh MF, Zhang G, Ouyang H, Zeng C, Yan B, et al. Improved accuracy of 3D-printed navigational template during complicated tibial plateau fracture surgery. Australas Phys Eng Sci Med. 2015;38(1):109-17. DOI: https://doi.org/10.1007/s13246-015-0330-0
Lal H, Patralekh M. 3D printing and its applications in orthopaedic trauma: A technological marvel. J Clin Orthop Trauma. 2018;9(3):260-8. DOI: https://doi.org/10.1016/j.jcot.2018.07.022
