Virtual surgical planning and use of a 3D‐printed, patient‐specific reduction system for minimally invasive plate osteosynthesis of diaphyseal tibial fractures in dogs: A historic case control study

• Published in: Veterinary surgery 2024-08, Vol.53 (6), p.1052-1061
• Main Authors: Scheuermann, Logan M., Lewis, Daniel D., Johnson, Matthew D., Biedrzycki, Adam H., Kim, Stanley E.
• Format: Article
• Language: English
• Subjects: Alignment; Animals; Bone Plates - veterinary; Case-Control Studies; Complications; Computed tomography; Control systems; Dog Diseases - surgery; Dogs; Dogs - injuries; Dogs - surgery; Female; Fluoroscopic imaging; Fluoroscopy; fracture fixation; Fracture Fixation, Internal - instrumentation; Fracture Fixation, Internal - methods; Fracture Fixation, Internal - veterinary; Fractures; Image acquisition; Male; Medical records; Minimally Invasive Surgical Procedures - methods; Minimally Invasive Surgical Procedures - veterinary; Osteosynthesis; Parameter identification; Patients; Population studies; Postoperative; Printing, Three-Dimensional; Prospective Studies; Surgery; Surgery, Computer-Assisted - methods; Surgery, Computer-Assisted - veterinary; Telesurgery; Tibia; Tibial Fractures - diagnostic imaging; Tibial Fractures - surgery; Tibial Fractures - veterinary; Tomography, X-Ray Computed - veterinary
• ISSN: 0161-3499; 1532-950X; 1532-950X
• DOI: 10.1111/vsu.14112

Objective To compare the efficacy and clinical outcomes of computed tomography (CT)‐based virtual surgical planning (VSP) and a three‐dimensional (3D)‐printed, patient‐specific reduction system to conventional indirect reduction techniques for diaphyseal tibial fractures stabilized using minimally invasive plate osteosynthesis (MIPO) in dogs. Study design A prospective clinical study with a historic control cohort. Sample population Dogs undergoing MIPO stabilization of diaphyseal tibial fractures using a custom 3D‐printed reduction system (3D‐MIPO; n = 15) or conventional indirect reduction techniques (c‐MIPO; n = 14). Methods Dogs were prospectively enrolled to the 3D‐MIPO group and CT scans were used to design and fabricate a custom 3D‐printed reduction system to facilitate MIPO. Medical records were searched to identify dogs for the c‐MIPO group. Pre‐, intra‐ and postoperative parameters were compared between groups. Results The duration from presentation until surgery was 23 h longer in the 3D‐MIPO group (p = .002). Fewer intraoperative fluoroscopic images were acquired (p  .1). Postoperative complications occurred in 27% and 14% of fractures in the 3D‐MIPO and c‐MIPO groups, respectively. Conclusion Both reduction methods yielded comparable results. Although the preoperative planning and guide preparation was time consuming, surgery times were shorter and fluoroscopy use was less in the 3D‐MIPO group. Clinical significance VSP and the custom 3D‐printed reduction system facilitated efficient MIPO.