Therapeutic Effect of Acetabular Fractures Using the Pararectus Approach Combined with
            3D
            Printing Technique

Abstract Background To explore the clinical efficacy of pararectus approach combined with 3D printing technique for the surgical treatment of partial complex acetabular fractures. Methods We retrospectively evaluated 18 (11 males and 7 females) patients with complicated acetabular fractures in the period of June 2017 to December 2018; According to judet-letenneal classification: 11 cases were of double column fracture, 6 fractures were of the anterior column with posterior half transverse, and 1 case was of "T" fracture. For all cases, 3D printing is used to print the acetabular model. Pre-bent reconstruction plates from the model were placed to fixate fractures after reduction via the pararectus approach. Results The average time of surgery was 203 min (range:135-245 min)and mean intraoperative blood loss was 1030ml(range:450-1400ml);18 patients were followed up for 12-18 months (average,14 months);One patient (5.6%) developed postoperative wound infection, and the wound completely improved by secretion culture, enhanced dressing and effective antibiotics. One patient (5.6%) developed postoperative ossifying myositis, and there are no obvious symptoms at present; all patients underwent pelvic films and pelvic CT+ three-dimensional reconstruction after surgery, suggesting that fractures reduction as well. All the acetabular fractures united after 12 to 16 weeks(average,13 weeks);According to the modified Merle d’Aubigne and Postel scoring system to assess the hip function: excellent in 13 cases (72.2%), good in 3 cases(16.7%) and fair in 2 cases(11.1%). Conclusions In the treatment of partial complex acetabular fractures, the pararectus approach combined with 3D printing technique can achieve effective reduction and fixation, decrease intraoperative hemorrhage, shorten operation time and the internal fixation position can be properly adjusted during the operation by looking directly at the model.

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Therapeutic effect of acetabular fractures using the Pararectus approach combined with 3D printing technique

10.21203/rs.2.23813/v2 ◽

2020 ◽

Author(s):

Ruyi Zou ◽

Min Wu ◽

Jianzhong Guan ◽

Yuzhou Xiao ◽

Xiaotian Chen

Keyword(s):

3D Printing ◽

Operation Time ◽

Anterior Column ◽

Acetabular Fractures ◽

Transverse Fracture ◽

Effective Reduction ◽

Printing Technique ◽

Hip Function ◽

Pararectus Approach ◽

3D Printing Technique

Abstract Objective: To explore the clinical efficacy of pararectus approach combined with 3D printing technique for the surgical treatment of partial acetabular fractures.Methods: We retrospectively evaluated 33 (20 males and 13 females) patients with acetabular fractures in the period of June 2017 to December 2018; According to judet-letenneal classification: 11 cases were of anterior column fracture, 10 cases were of double column fracture, 7 fractures were of the anterior column with posterior half transverse,3 fractures were of transverse fracture, and 2 case was of "T" fracture. For all cases, 3D printing is used to print the acetabular model. Pre-bent reconstruction plates from the model were placed to fixate fractures via the pararectus approach. Results : Thirty-three patients were followed up for 12-18 months (average,14 months); two patients (6.0%) developed postoperative ossifying myositis, and there are no obvious symptoms at present; One patient (3.0%) developed postoperative wound infection, and the wound completely improved by secretion culture, enhanced dressing and effective antibiotics; All the acetabular fractures united after 12 to 16 weeks(average,13 weeks);According to the modified Merle d’Aubigne and Postel scoring system to assess the hip function: excellent in 22 cases (66.7%), good in 7 cases(21.2%) and fair in 4 cases(12.1%).Conclusions: In the treatment of partial acetabular fractures, the pararectus approach combined with 3D printing technique can achieve effective reduction and fixation, decrease intraoperative hemorrhage, shorten operation time and the internal fixation position can be properly adjusted during the operation by looking directly at the model.

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