Meta-analysis On The Efficacy Of 3G-print-assisted Surgery Versus Conventional Surgery For Proximal Humeral Fractures

Objective: Through collecting the literature on the application of 3D printing technology in the surgical treatment of proximal humeral fracture,and to investigate the effect of 3D printing technology on the surgical effect of proximal humeral fracture.Methods: By searching the related literature about proximal humeral fractures on CNKI,Wanfang Data,CBMdisc,China Science Technology Journal Database,Web of Science,Pub Med search and Cochrane Library etc,to find the application of 3D printing auxiliary operation of proximal humeral fractures clinical research literature.Screened the literatures according to the inclusion criteria or exclusion criteria,and the quality of the included literatures was evaluated using the modified Jadad scale.The index data of the final literatures were collected,and Meta-analysis was performed using Rev Man5.3 software.Results: Operation time index and intraoperative blood loss index were included in 8 randomized controlled trials that contain 580 patients,including289 patients in the 3D printing group and 291 patients in the conventional surgery group.The results of meta-analysis show that the operative time [MD=-29.06,95%CI(-41.98,-16.14)] and the amount of intraoperative blood loss[MD=-49.13,95%CI(-74.18,-24.08)] in the 3D group were significantly lower than those in the conventional group.The number of intraoperative C-arm fluoroscopy was included in 3 randomized controlled trials that 230 patients were included,including 116 patients in the 3D printing group and 114 patients in the conventional surgery group.The number of intraoperative C-arm fluoroscopy in the 3D group [MD=-3.04,95%CI(-3.37,-2.72)] indicated that the3 D printing group was superior to the conventional surgery group in reducing the number of intraoperative C-arm fluoroscopy.Except the healing time after fracture [MD=-1.22,95%CI(-2.95,0.48),P<0.05,there was no significant statistical difference between the two groups],postoperative drainage rate [MD=-8.30,95%CI(-10.91,-5.68)] and postoperative Neer function score [MD=2.98,95%CI(1.82,4.14)],indicating that the 3D printing group was superior to the conventional surgery group.Conclusions: Assisted by 3D printing,proximal humeral surgery can shorten operative time reducing operative bleeding,c-arm fluoroscopy times,postoperative drainage,as well as accelerating postoperative motor function recovery(higher postoperative Neer score).