Efficacy of Virtual Surgical Planning and 3D-Printed Patient-Specific Reduction Guides for Aligning Simulated Comminuted Tibial Fractures in Cadaveric Dogs

Introduction: Fabrication and application of three-dimensional (3D)-printed patient-specific guides may be useful to facilitate accurate reduction and alignment during minimally invasive plate osteosynthesis (MIPO) fracture stabilization. The purpose of this study was to assess the feasibility and accuracy of using 3D-printed patient-specific pin guides and two reduction methods to align simulated fractures to facilitate MIPO applications. We hypothesized that use of a patient-specific fracture reduction guide would result in more efficient indirect fracture reduction with less variability in length and alignment than application of a linear type 1A external fixator. Materials and Methods: Computerized tomographic (CT) images were obtained of both tibiae in eight dog cadavers. Three-dimensional reconstructions of the tibiae were used to create proximal and distal patient-specific pin guides. These guides were printed and used to facilitate fracture reduction in conjunction with either a linear type 1A external fixator or 3D-printed reduction guide. Post-reduction CT images were obtained to assess accuracy of pin guide placement as well as accuracy of fracture reduction and alignment. Results: Fracture reduction utilizing the 3D-printed reduction guides was subjectively easier ( p = 0.03) and significantly faster ( p = 0.02) than application of a linear type 1A external fixator. Guides for both groups were placed with small, but detectable deviations from the planned placement ( p = 0.01). Fracture reduction resulted in similar minor morphologic differences from the intact tibia ( p < 0.02) with no difference in alignment between groups ( p >0.3). Discussion/Conclusion: Patient-specific 3D printed pin and reduction guides have the potential to facilitate fracture reduction and alignment during MIPO fracture stabilization. Acknowledgements: Study funding is provided by the University of Florida College of Veterinary Medicine SACS Research Grant Competition (2019). Publication History Article published online: 26 October 2022 © 2022. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany