Three dimensional printing technology and materials for treatment of elbow fractures

• Published in: International orthopaedics 2017-11, Vol.41 (11), p.2381-2387
• Main Authors: Yang, Long, Grottkau, Brian, He, Zhixu, Ye, Chuan
• Format: Article
• Language: English
• Subjects: Acrylic Resins; Adult; Arm Injuries - surgery; Butadienes; Elbow Joint - injuries; Female; Fracture Fixation, Internal - adverse effects; Fracture Fixation, Internal - methods; Fractures, Bone - surgery; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Models, Anatomic; Original Paper; Orthopedics; Patient Satisfaction - statistics & numerical data; Physician-Patient Relations; Polyesters; Polystyrenes; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Printing, Three-Dimensional; Surgeons; Surgery, Computer-Assisted - adverse effects; Surgery, Computer-Assisted - methods; Surveys and Questionnaires; Young Adult
• ISSN: 0341-2695; 1432-5195
• DOI: 10.1007/s00264-017-3627-7

Purpose 3D printing is a rapid prototyping technology that uses a 3D digital model to physically build an object. The aim of this study was to evaluate the peri-operative effect of 3D printing in treating complex elbow fractures and its role in physician–patient communication and determine which material is best for surgical model printing. Method Forty patients with elbow fractures were randomly divided into a 3D printing-assisted surgery group ( n  = 20) and a conventional surgery group ( n  = 20). Surgery duration, intra-operative blood loss, anatomic reduction rate, incidence of complications and elbow function score were compared between the two groups. The printing parameters, the advantages and the disadvantages of PLA and ABS were also compared. The independent-samples t-test was used to compare the data between groups. A questionnaire was designed for orthopaedic surgeons to evaluate the verisimilitude, the appearance of being true or real, and effectiveness of the 3D printing fracture model. Another questionnaire was designed to evaluate physician–patient communication effectiveness. Results The 3D group showed shorter surgical duration, lower blood loss and higher elbow function score, compared with the conventional group. PLA is an environmentally friendly material, whereas ABS produce an odour in the printing process. Curling edges occurred easily in the printing process with ABS and were observed in four of ten ABS models but in only one PLA model. The overall scores given by the surgeons about the verisimilitude and effectiveness of the 3D model were relatively high. Patient satisfaction scores for the 3D model were higher than those for the 2D imaging data during physician–patient discussions. Conclusion 3D-printed models can accurately depict the anatomic characteristics of fracture sites, help surgeons determine a surgical plan and represent an effective tool for physician–patient communication. PLA is more suitable for desktop fused deposition printing in surgical modeling applications.