Study On The Application Value Of 3D Printing Technology For Complex Acetabular Fracture Repair

Objective: To explore the application value of 3D printing technology in the treatment of complex acetabular fractures.Methods: A retrospective analysis of 50 patients with complicated acetabular fractures who underwent surgical treatment and was followed up in the Department of Trauma and Orthopaedics,First Affiliated Hospital of Xinjiang Medical University from January 2017 to December 2018.Twenty-one patients underwent CT three-dimensional reconstruction,3D printing rapid prototyping and individualized specimen simulation surgery(3D group): 14 males and 7 females;mean age(47.2±11.5)years old.Twenty-nine patients did not use 3D printing technology(regular group): 18 males and 11 females;mean age(45.7±10.8)years old.The anterior acetabular fractures of the 3D group and the conventional group were performed by Letournel-Judet classification: 4 and 6 cases of T-shaped fractures,5 and 6 cases of posterior column fractures,6 and 9 cases of transverse shape with posterior wall fractures,and 1 and 2 cases anterior and posterior transverse fractures,5 and 6 cases of double column fracture.The operation time,perioperative blood transfusion,intraoperative blood loss,intraoperative fluoroscopy,postoperative complications and other indicators were recorded.The Mata score was used to assess the quality of postoperative acetabular fracture reduction.The modified Merle D’Aubigné and Postel scores were used for functional evaluation of postoperative acetabular fractures at the last follow-up.There was no statistically significant difference in preoperative general data among the 2 groups(P>0.05),they arecomparable.Results: All patients were followed for 3 months to 2 years(12months on average).Compared with the conventional group,the operation time of the 3D technique group was shortened,the perioperative blood transfusion volume was small,the intraoperative blood loss was small,the intraoperative fluoroscopy was small,and the incidence of postoperative complications was low.The divisions between the two groupswas statistically significant.(P < 0.05).According to the Matta scoring standard,the quality of fracture reduction was evaluated: 3D technical group: excellent in 15 cases,good in 3 cases,fair in 3 cases,excellent rate was 85.7%;conventional group: excellent in17 cases,good in 7 cases,fair in 4 cases,poor in 1 case,The excellent and good rate was82.8%.There was no statistically significant difference among the 2 groups(P>0.05).According to the modified Merle D’Aubigné and Postel scores,the function of postoperative acetabular fractures was evaluated: 3D technique group,excellent in 12 cases,good in 4 cases,fair in 4 cases,poor in 1 case,excellent rate was 76.19%;conventional group: excellent: 15 cases,good in 6 cases,fair in 6 cases,poor in 2 cases,the excellent rate was 72.41%.There was no significant difference between the two groups(P>0.05).Conclusion: 3D printing technology has a good clinical value for the treatment of complex acetabular fractures.Preoperative use of individualized 3D printing technology and simulated surgery can improve the surgical efficiency of complex acetabular fractures,reduce postoperative complications,and shorten surgery.Time,improve the safety of perioperative period.