The accuracy and safety of patient-specific 3D printing screws insertion templates based on external fixation for pelvic screw insertion

11 pages•Published: July 12, 2018

Xing-Guang Tao, Hui Liang, Fu-Gen Pan and Kai Hua Zhou

Abstract

Objective: To explore the feasibility and accuracy of the new technique of patient-specific 3D printing screws insertion template in the pelvic fractures.
Methods: From January to June in 2017, 6 patients with pelvic fractures were treated by this new type of screw guide templates. Pubis screws and sacroiliac screws were inserted. The patients with external fixation were examined by CT scan before surgery. The patients-specific 3D printing templates were made with photosensitive resin by a 3D printing system to ensure the trajectory of the screws. The templates were sterilized by ethylene oxide and used during surgery. The accuracy and safety of the templates were evaluated by CT scans after surgery.
Results: Totally 10 screws were inserted, including 5 pubis screws and 5 sacroiliac screws. The average surgical time for pubis screw was 12.7 min/screw, and 9.2 min/screw for sacroiliac screw. The average time of X-ray exposure was 13.3±3.6s/screw for public screw and 9.6±4.5s/screw for sacroiliac screw. All the screws were inserted in the trajectory as preoperative design and the screw axis deviation was 1.60 ± 0.2mm and 2 ± 0.3 degrees angle deviation by preoperative and postoperative CT verification. Blood loss during the surgery was minimal (12.2ml/screw). Vascular of neurologic complications or injuries did not happen. And no infection, broken screws or screw pullout occurred.
ConculsionThe patient-specific screw guide template based on the external fixation can insert the screw accurately and safely with very small incision. This technique is a new kind of intraoperative screw navigations. The patient-specific 3D printing screw insertion template was user-frindly, moderate cost and enabled a radiation-reduced pelvic screw insertion.

Keyphrases: 3d print, external fixation, pelvis fracture, template

In: Wei Tian and Ferdinando Rodriguez Y Baena (editors). CAOS 2018. The 18th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery, vol 2, pages 208-218.

Links:	https://easychair.org/publications/paper/wKBV
	https://doi.org/10.29007/96k5

BibTeX entry

@inproceedings{CAOS2018:accuracy_safety_patient_specific,
  author    = {Xing-Guang Tao and Hui Liang and Fu-Gen Pan and Kai Hua Zhou},
  title     = {The accuracy and safety of patient-specific 3D printing screws insertion templates based on external fixation for pelvic screw insertion},
  booktitle = {CAOS 2018. The 18th Annual Meeting of the International Society for Computer Assisted Orthopaedic Surgery},
  editor    = {Wei Tian and Ferdinando Rodriguez Y Baena},
  series    = {EPiC Series in Health Sciences},
  volume    = {2},
  publisher = {EasyChair},
  bibsource = {EasyChair, https://easychair.org},
  issn      = {2398-5305},
  url       = {/publications/paper/wKBV},
  doi       = {10.29007/96k5},
  pages     = {208-218},
  year      = {2018}}

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