Three-dimensional printing and patient-specific pre-contoured plate: future of acetabulum fracture fixation?

Due to the complexity of acetabulum, achieving anatomical contouring intra-operatively is difficult for surgeon. A 3D (dimensional) real model can facilitate us both in contouring the plate pre-operatively and in better pre-operative planning. Patient-specific pre-contoured plate in acetabular fracture has been studied by few researchers but randomized case–control study was lacking. Hence, we conducted a case–control study to evaluate the accuracy of patient-specific pre-contoured plate.

Prospective randomized case control study was conducted. 21 patients were included. 10 patients were distributed in “case” group and remaining 11 in “control” group. Inclusion criteria: Displaced acetabulum fractures with displacement of ≥3 mm in adults who reported within 3 weeks of injury. Exclusion criteria were: Open fractures, associated Morel-Lavallée lesion and patients with >3 weeks old fracture. In case group, patient-specific real 3D model of fractured acetabulum was generated using rapid prototyping technology and plates were contoured pre-operatively. Control group was treated using intra-operative contoured plates. Both the groups were compared using parameters: Blood loss, Surgery time, post-operative reduction on X-ray, post-surgical residual displacement and reduction achieved as evaluated by CT scan.

Patient-specific pre-contoured plate made using 3D model is a better implant than intra-operatively contoured plate. Real-time 3D pelvis model is an accurate technique for pre-operative planning in acetabular fractures.