Treatment Of Articular-depression Tibial Plateau Fractures With Raft Screws Technique And 3D Printing

Objective To investigate the clinical effectiveness in treating articular-depression tibial plateau fractures by using the rafting screws and 3D printing.Methods The clinical data of 41 patients with articular-depression tibial plateau fractures treated by open reduction with rafting screws in this hospital between September 2013 and September 2015 were retrospectively analyzed.According to the different preoperative preparations,they were divided into 3D group(16 cases)and traditional group(25 cases).Patients in 3D group were treated with 3D printing technology as preoperative preparation,including preoperative planning and surgical training in the model,while patients in traditional group underwent routine preoperative preparation.Comparison between the two groups were made in operation time,blood loss,perioperative complication rate,successfully fracture reduction rate,knee function score and articular second depression.Results All patients were followed up.The follow-up was 11.71 months on average(ranged 9 to 18 months),Between 3D group and traditional group,there were significant difference in operation time(80.94±18.09 min and 101.40 ± 18.34min)?blood loss(77.19±24.36 ml and 111.60±38.64ml)?successfully fracture reduction rate(100% and 72%)and the Rasmussen knee function score(24.88±5.32 points and 20.36±7.44 points).Patients in group 3D had no complications during perioperative period,while in traditional group,there appeared 1 cases with arteriae tibialis anterior injury and another 1 cases with incision infection,who treated by continuous changeover.There was 1 patient appeared articular-depression in 3D group while 4 patients in traditional group after 9 months follow up,the collapse rate was 6.25% and 16% respectively,there were no significant difference about perioperative complication rate and articular second depression rate between the two groups(P>0.05).Conclusion In the treatment of articular-depression tibial plateau fractures,the technique of rafting screws and 3D printing can reduce the operation time and blood loss,improve the efficiency of fracture reduction and the knee function.