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Background

To report our experiences with the use of three-dimensional (3D) printing in the field of orthopedic trauma.

Methods

This retrospective study enrolled 24 patients from three university teaching hospitals in whom 3D printing technique was applied: 14 patients with acetabular fractures and 10 patients with clavicular shaft fractures. We summarized our experiences with 3D printed bone models.

Results

Three-dimensional printed acetabular models improved understanding of complex acetabular anatomy and fracture pattern to plan the optimal positioning of a reduction clamp and the trajectory of screws. Pre-bending of a reconstruction plate could reduce operative time. We also recorded fluoroscopic images of a simulated surgery for percutaneous screw fixation of the acetabular posterior column, with the optimal positioning of the guide wire determined during the simulation used as a reference during the actual operation. This surgical simulation was performed by a resident and served as a helpful training method. For fractures of the clavicle, we identified the optimal position of anatomical plates using 3D printed clavicle models.

Conclusion

In our experience, 3D printing technique provided surgeons with improved understanding of the fracture pattern and anatomy and was effectively used for preoperative planning, education of surgical trainees, and performing simulations to improve intra-operative technical outcomes.  相似文献   

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L.B. Ong  K. Satku  P.H.C. Lim 《Injury》1981,12(6):466-470
Closed medullary nailing for fracture of the femoral shaft was carried out in 101 cases. The operation was performed with the patient in the supine position and without reaming the medullary canal, using the conventional instruments and rigid guide pins. The diameter of the medullary canal was gauged from standard radiographs taken at 1 m tube-to-film distance. To secure alignment and reduction of the fracture, heavy traction before and during the operation was necessary. The traction applied on a fracture table against the restraining perineal bar caused trauma to the perineal structures in 7 cases. There was no case of deep infection. The fixation of the fracture was by no means rigid but was adequate for early walking and partial weight bearing. When nails with diameters of less than 9 mm were used, a number of complications occurred. These included angulation, rotational instability at the fracture site, fracture of the nail and non-union. Union occurred within 3 months in all except 2 cases. Nearly 60 per cent of the patients were in hospital for less than 2 weeks. Closed medullary nailing of the femur is preferable to the open method, which carries a much higher risk of infection.  相似文献   

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Sixteen patients with choledochal cysts were encountered in 13 yr. In three the cyst had ruptured and in two there was intrahepatic ductal dilatation. Observations concerning diagnosis, surgical management, and the complications of treatment are made in detail.  相似文献   

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