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European Journal of Trauma and Emergency Surgery

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01-12-2021 | Review Article

Comparison of the feasibility of 3D printing technology in the treatment of pelvic fractures: a systematic review and meta-analysis of randomized controlled trials and prospective comparative studies

Authors: Jinwu Wang, Xingyu Wang, Bingzhang Wang, Linzhen Xie, Wenhao Zheng, Hua Chen, Leyi Cai

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2021

Abstract

Purpose

The objective of this meta-analysis was to assess the influence of 3D printing technology on the open reduction and internal fixation (ORIF) of pelvic fractures from current randomized controlled trials and prospective comparative studies.

Methods

In this meta-analysis, we conducted electronic searches of Pubmed, Embase, Cochrane library, Web of Science and CNKI up to February 2020. We collected clinical controlled trials using 3D printing-assisted surgery and traditional techniques to assist in pelvic fractures, evaluating the quality of the included studies and extracting data. The data of operation time, blood loss, follow-up function (Majeed function score), quality of fracture reduction (Matta score) and complications (infection, screw loosening, pelvic instability, venous thromboembolism, sacral nerve injury) were extracted. Stata 12.0 software was used for our meta-analysis.

Results

Five RCTs and 2 prospective comparative studies met our inclusion criteria with 174 patients in the 3D printing group and 174 patients in the conventional group. There were significant differences in operation time [SMD = − 2.03], intraoperative blood loss [SMD = − 1.66] and postoperative complications [RR = 0.17] between the 3D group and conventional group. And the excellent and good rate of pelvic fracture reduction in the 3D group [RR = 1.32], the excellent and good rate of pelvic function [RR = 1.29] was superior to the conventional group.

Conclusions

The 3D group showed shorter operation time, less intraoperative blood loss, less complications, better quality of fracture reduction and fast function recovery. Therefore, compared with conventional ORIF, ORIF assisted by 3D printing technology should be a more appropriate treatment of pelvic fractures.

Tile M. Acute pelvic fractures: I. Causation and classification. J Am Acad Orthop Surg. 1996;4(3):143–51.PubMed

Breuil V, Roux CH, Carle GF. Pelvic fractures: epidemiology, consequences, and medical management. Curr Opin Rheumatol. 2016;28(4):442–7.CrossRef

Abrassart S, Stern R, Peter R. Unstable pelvic ring injury with hemodynamic instability: what seems the best procedure choice and sequence in the initial management? Orthop Traumatol Surg Res. 2013;99(2):175–82.PubMedCrossRef

Sheth R, Balesh ER, Zhang YS, Hirsch JA, Khademhosseini A, Oklu R. Three-dimensional printing: an enabling technology for IR. J Vasc Interv Radiol. 2016;27(6):859–65.PubMedCrossRef

Mao ZG, Jiang YW, Mao JH, Tong PJ. Application of 3D printing technology in the complex acetabular prosthesis revision surgery:a case report. Zhongguo Gu Shang. 2016;29(11):1058–60.PubMed

Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med. 2009;6(7):e1000097.CrossRef

Cumpston M, Li T, Page MJ, Chandler J, Welch VA, Higgins JP, et al. Updated guidance for trusted systematic reviews a new edition of the cochrane handbook for systematic reviews of interventions. Cochrane Database Syst Rev. 2019;10:ED000142.PubMed

Chuling F, Hui H, Zuojun X. The Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized studies. Syst Rev Meta PloS one. 2016;13(12):e0208725.

Lin L. Feasibility study of 3D printing technology in the treatment of complex pelvic fractures. Modern Hosp. 2018;18(6):883–90.

10.

Chen X, Chen B, Li T, Shi S, Zhu Y. Clinical analysis of 3D printing technique assisted anterior minimally invasive approach in the treatment of unstable pelvic fracture. Progress Modern Biomed. 2018;018(12):2325–8.

11.

Lan XY, Zhang ZP, Dong YE, Liao XQ, Orthopedics DO. Application value of 3D printing technique in pelvic fracture repair. China Modern Med. 2018;1:4–7.

12.

Wang Z. Application value of 3D printing technique in patients with freshly closed pelvic fractur. Internat Med Health Guidance News. 2017;23(23):3695–8.

13.

Li M, Chen R, Zhong H. Application of 3D printing in digital design of pelvic fracture. Med Equip. 2018;31(17):1–2.

14.

Fan L, He B, Wang B, Qin H, Wang Y. Appficafion of 3D printing technology and individualized treatment in pelvic fracture. Orthop Biomech Mater Clin Study. 2018;15(2):44–7.

15.

Huang L, Wu P. The application and curative effect of 3D printing in pelvic fracture surgery. Health Guide. 2017;7:176.

16.

Majeed SA. Grading the outcome of pelvic fractures. J Bone Jt Surg Br. 1989;71(2):304–6.CrossRef

17.

Matta JM, Tornetta P 3rd. Internal fixation of unstable pelvic ring injuries. Clin Orthop Relat Res. 1996;329:129–40.CrossRef

18.

JM M. Operative treatment of acetabular fractures through the ilioinguinal approach. A 10-year perspective. Clin orthop related res. 1994;305:10–9.

19.

Cai L, Zhang Y, Chen C, Lou Y, Guo X, Wang J. 3D printing-based minimally invasive cannulated screw treatment of unstable pelvic fracture. J Orthop Surg Res. 2018;13(1):71.PubMedPubMedCentralCrossRef

20.

Li L, Gao J, Bi L, Yuan Z, Pei G. Comparison of three-dimensional printing and conventional imaging in surgical treatment of Tile C pelvic fractures: a long-term follow-up study. Int J Clin Exp Med. 2017;10(8):12433–9.

21.

Hung CC, Li YT, Chou YC, Chen JE, Wu CC, Shen HC, et al. Conventional plate fixation method versus pre-operative virtual simulation and three-dimensional printing-assisted contoured plate fixation method in the treatment of anterior pelvic ring fracture. Int Orthop. 2019;43(2):425–31.PubMedCrossRef

22.

Bruyere F, Leroux C, Brunereau L, Lermusiaux P. Rapid prototyping model for percutaneous nephrolithotomy training. J Endourol. 2008;22(1):91–6.PubMedCrossRef

23.

Lim CG, Campbell DI, Clucas DM. Rapid prototyping technology in orbital floor reconstruction: application in three patients. Craniomaxillofac Trauma Reconstr. 2014;7(2):143–6.PubMedPubMedCentralCrossRef

24.

Sodian R, Schmauss D, Schmitz C, Bigdeli A, Haeberle S, Schmoeckel M, et al. 3-dimensional printing of models to create custom-made devices for coil embolization of an anastomotic leak after aortic arch replacement. Ann Thorac Surg. 2009;88(3):974–8.PubMedCrossRef

25.

Schievano S, Migliavacca F, Coats L, Khambadkone S, Carminati M, Wilson N, et al. Percutaneous pulmonary valve implantation based on rapid prototyping of right ventricular outflow tract and pulmonary trunk from MR data. Radiology. 2007;242(2):490–7.PubMedCrossRef

26.

Mottl-Link S, Hubler M, Kuhne T, Rietdorf U, Krueger JJ, Schnackenburg B, et al. Physical models aiding in complex congenital heart surgery. Ann Thorac Surg. 2008;86(1):273–7.PubMedCrossRef

27.

Toso F, Zuiani C, Vergendo M, Salvo I, Robiony M, Politi M, et al. Usefulness of computed tomography in pre-surgical evaluation of maxillo-facial pathology with rapid prototyping and surgical pre-planning by virtual reality. Radiol Med. 2005;110(5–6):665–75.PubMed

28.

Chow LK, Cheung LK. The usefulness of stereomodels in maxillofacial surgical management. J Oral Maxillofac Surg. 2007;65(11):2260–8.PubMedCrossRef

29.

Zhou LB, Shang HT, He LS, Bo B, Liu GC, Liu YP, et al. Accurate reconstruction of discontinuous mandible using a reverse engineering/computer-aided design/rapid prototyping technique: a preliminary clinical study. J Oral Maxillofac Surg. 2010;68(9):2115–21.PubMedCrossRef

30.

Parchi PD, Ferrari V, Piolanti N, Andreani L, Condino S, Evangelisti G, et al. Computer tomography prototyping and virtual procedure simulation in difficult cases of hip replacement surgery. Surg Technol Int. 2013;23:228–34.PubMed

31.

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.PubMedCrossRef

32.

Murray DJ, Edwards G, Mainprize JG, Antonyshyn O. Advanced technology in the management of fibrous dysplasia. J Plast Reconstr Aesthet Surg. 2008;61(8):906–16.PubMedCrossRef

33.

Ciocca L, Fantini M, De Crescenzio F, Persiani F, Scotti R. Computer-aided design and manufacturing construction of a surgical template for craniofacial implant positioning to support a definitive nasal prosthesis. Clin Oral Implants Res. 2011;22(8):850–6.PubMedCrossRef

34.

Jirman R, Horak Z, Mazanek J, Reznicek J. Individual replacement of the frontal bone defect: case report. Prague Med Rep. 2009;110(1):79–84.PubMed

Title: Comparison of the feasibility of 3D printing technology in the treatment of pelvic fractures: a systematic review and meta-analysis of randomized controlled trials and prospective comparative studies
Authors: Jinwu Wang
Xingyu Wang
Bingzhang Wang
Linzhen Xie
Wenhao Zheng
Hua Chen
Leyi Cai
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2021
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-020-01532-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparison of the feasibility of 3D printing technology in the treatment of pelvic fractures: a systematic review and meta-analysis of randomized controlled trials and prospective comparative studies

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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