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Kassem M, Hagras MA, Elsheikh MN, Erfan FA, Amer M. Efficacy of Three-Dimensional Printing in the Management of Frontal Bone Trauma. J Neurol Surg B Skull Base 2025; 86:353-359. [PMID: 40351882 PMCID: PMC12064307 DOI: 10.1055/a-2321-0223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 04/23/2024] [Indexed: 05/14/2025] Open
Abstract
Objectives Craniomaxillofacial (CMF) trauma surgery is difficult because of its unique architecture and vast range of injuries in the head and neck area. This study sought to determine the potential of employing preoperative three-dimensional (3D)-printed models to improve frontal fracture healing outcomes. Methods This prospective cohort clinical trial involved 20 patients who were surgically fitted and had a frontal bone fracture, as evidenced by computed tomography. The patients were separated into two groups: Group A: patients with frontal bone trauma reduced using 3D printing; and Group B: patients with frontal bone trauma reduced without 3D printing. Results Compared to Group B, Group A had a considerably shorter operational time ( p < 0.001). The esthetic results, complications, and functional outcomes were not significantly different between the two groups. All patients in Groups A and B underwent accurate radiographic evaluations (correct placement of the titanium mesh). Conclusion 3D printing in preoperative planning improves frontal fracture repair with respect to operative length but does not reduce intraoperative blood loss or improve postoperative function compared with normal management.
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Affiliation(s)
- Mohamed Kassem
- Department of Otolaryngology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mahmoud Abd Hagras
- Department of Otolaryngology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | | | - Fathhe Ali Erfan
- Department of Otolaryngology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Mohamed Amer
- Department of Otolaryngology, Faculty of Medicine, Tanta University, Tanta, Egypt
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Al-Obaidi I, Kendal A, Ramasamy A. Advances in foot and ankle surgery : a review of recent innovations. Bone Joint J 2025; 107-B:283-290. [PMID: 40020719 DOI: 10.1302/0301-620x.107b3.bjj-2024-0873.r2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/03/2025]
Abstract
The last five years have seen notable advancements in foot and ankle surgery as a result of technical innovations and more consistent reporting of results. Much progress has been made in improving patient-reported outcome measures, in the development of basic research in this area, and in the development of personalized approaches which optimize outcomes for specific groups of patients. This review focuses on five main areas of development within foot and ankle surgery: ankle arthroplasty, osteomyelitis and the diabetic foot, sports injuries, minimally invasive surgery, and orthobiologics. The aim of this annotation is to discuss the progress made in these fields during recent years and propose avenues for further development.
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Affiliation(s)
| | - Adrian Kendal
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Nuffield Orthopaedic Centre, Oxford, UK
| | - Arul Ramasamy
- Sir Michael Uren Building, White City Campus, London, UK
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Wood L, Ahmed Z. Does using 3D printed models for pre-operative planning improve surgical outcomes of foot and ankle fracture fixation? A systematic review and meta-analysis. Eur J Trauma Emerg Surg 2024; 50:21-35. [PMID: 36418394 PMCID: PMC10924018 DOI: 10.1007/s00068-022-02176-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 11/11/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE The systematic review aims to establish the value of using 3D printing-assisted pre-operative planning, compared to conventional planning, for the operative management of foot and ankle fractures. METHODS The systematic review was performed according to PRISMA guidelines. Two authors performed searches on three electronic databases. Studies were included if they conformed to pre-established eligibility criteria. Primary outcome measures included intraoperative blood loss, operation duration, and fluoroscopy time. The American orthopaedic foot and ankle score (AOFAS) was used as a secondary outcome. Quality assessment was completed using the Cochrane RoB2 form and a meta-analysis was performed to assess heterogeneity. RESULTS Five studies met the inclusion and exclusion criteria and were eventually included in the review. A meta-analysis established that using 3D printed models for pre-operative planning resulted in a significant reduction in operation duration (mean difference [MD] = - 23.52 min, 95% CI [- 39.31, - 7.74], p = 0.003), intraoperative blood loss (MD = - 30.59 mL, 95% CI [- 46.31, - 14.87], p = 0.0001), and number of times fluoroscopy was used (MD = - 3.20 times, 95% CI [- 4.69, - 1.72], p < 0.0001). Using 3D printed models also significantly increased AOFAS score results (MD = 2.24, 95% CI [0.69, 3.78], p = 0.005), demonstrating improved ankle health. CONCLUSION The systematic review provides promising evidence that 3D printing-assisted surgery significantly improves treatment for foot and ankle fractures in terms of operation duration, intraoperative blood loss, number of times fluoroscopy was used intraoperatively, and improved overall ankle health as measured by the AOFAS score.
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Affiliation(s)
- Lea Wood
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Zubair Ahmed
- College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
- Neuroscience and Ophthalmology, Institute of Inflammation and Ageing, College of Medical and Dental Science, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
- Centre for Trauma Sciences Research, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.
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Miao K, Wang J, Yu K, Hong J, Lu X. Percutaneous reduction and cannulated screw fixation assisted by 3D printing technology of calcaneal fractures in children. J Orthop Sci 2024; 29:236-242. [PMID: 36550014 DOI: 10.1016/j.jos.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/05/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Percutaneous reduction and cannulated screw fixation (PR + CSF) for treatment of calcaneal fractures in pediatric patients has been proven to achieve satisfactory outcomes with few complications. But it is also a difficult technology due to the limited exposure and surgeons are unable to reduce articular surface under direct vision. The purpose of this study was to analyze the outcomes of applying 3D printing technology to preoperative preparation and Intraoperative operating for the treatment of calcaneal fractures in children. METHODS Pediatric patients with calcaneal fractures from January 2010 to December 2018 were reviewed during study period. Preoperative radiographs and computed tomography scans were collected to classify the fractures, reconstruct 3D printed model and evaluate postoperative outcomes. The blood loss, operative time, number of fluoroscopies, surgeon and patient satisfaction were used to assess the effectiveness, feasibility and safety of 3D printing technology. Functional results were measured by American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score. RESULT 12 patients (10 boys and 2 girls) with 17 fractures were involved in our study. There were significant differences in the average Böhler angle before operation compared with that after operation and at last follow-up (P < 0.001). Similarly, the calcaneal height and length postoperatively and at the end of follow-up time were proved to have significant difference (P < 0.05) compared to preoperative. CT scan showed good reduction of the posterior facet according to Goldzak index. The average subjective AOFAS hindfoot score was 94.1. Both patients and surgeon made sense of the 3D printed model that can help them getting more information about the factures and making preoperative plans. No wound complication was found in this study. CONCLUSION This study indicated that percutaneous reduction and cannulated screw fixation (PR + CSF) assisted by 3D printing technology in the treatment of calcaneal fractures in pediatric patients achieve good outcomes, with specific preoperative preparation, satisfactory functional recovery and fewer complications. LEVEL OF EVIDENCE III.
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Affiliation(s)
- Keze Miao
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Department of Orthopaedics Surgery, China.
| | - Jianshun Wang
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Department of Orthopaedics Surgery, China.
| | - Kehe Yu
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Department of Orthopaedics Surgery, China.
| | - Jianjun Hong
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Department of Orthopaedics Surgery, China.
| | - Xiaolang Lu
- The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Department of Orthopaedics Surgery, China.
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Song Q, Li T, Xia H, Li Y, Feng C, Lin Y, Wang H, Hu J, Jiang Q. Three-dimensional printed cast assisted screw fixation of calcaneal fractures: a prospective study. BMC Musculoskelet Disord 2023; 24:802. [PMID: 37817109 PMCID: PMC10563275 DOI: 10.1186/s12891-023-06927-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/28/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Treatment of displaced intra-articular calcaneal fractures (DIACFs) with percutaneous screw fixation remains defective in some aspects. A novel three-dimensional (3D) printed cast was devised to assist screw placement. This study assessed the radiological and functional outcomes of 3D-printed cast assisted screw fixation for patients with DIACFs. METHODS Patients with unilateral Sanders type II or III DIACFs admitted to a single-centre hospital underwent either 3D-printed cast assisted screw fixation (3D group) or minimally invasive plate fixation (control group) from September 2020 to November 2022. All patients were assessed at one, two, three, and six months of follow-up. Comparison between groups was conducted in operative duration, fluoroscopic times, radiographic measurements of the calcaneus, and the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Score. RESULTS A total of 32 patients were enrolled (19 in the 3D group versus 13 in the control group). Significant differences were detected between the 3D group and control group in operative duration (53.63±8.95 min, 95.08±8.31 min, P <0.001), fluoroscopic times (7.37±1.21, 16.85±1.57, P <0.001). At a follow-up of six months, the 3D group showed better restoration than the control group in calcaneal width, height, Bohler angle, and AOFAS Ankle-Hindfoot scores (all P <0.001). No significant differences were shown in calcaneal length and Gissane angle (P >0.05). No wound-related complications occurred in either group. CONCLUSION The 3D-printed cast assisted screw fixation has shown superiority over minimally invasive plate fixation in the operative duration, fluoroscopic exposure, morphological restoration of the calcaneus, and functional outcomes in the treatment of DIACFs.
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Affiliation(s)
- Qizhi Song
- Department of Orthopaedic Surgery, Chonggang General Hospital, Chongqing, China
| | - Tao Li
- Department of Orthopaedic Surgery, Chonggang General Hospital, Chongqing, China
| | - Huan Xia
- Nursing Department, Chonggang General Hospital, Chongqing, China
| | - Yan Li
- Central Sterile Supply Department, Chonggang General Hospital, Chongqing, China
| | - Chengbin Feng
- Department of Orthopaedic Surgery, Chonggang General Hospital, Chongqing, China
| | - Yajun Lin
- Department of Orthopaedic Surgery, Chonggang General Hospital, Chongqing, China
| | - Huahong Wang
- Department of Orthopaedic Surgery, Chonggang General Hospital, Chongqing, China
| | - Jinbiao Hu
- Department of Orthopaedic Surgery, Chonggang General Hospital, Chongqing, China
| | - Qilong Jiang
- Department of Orthopaedic Surgery, Chongqing Orthopedic Hospital of Traditional Chinese Medicine, No. 9, Jiefang West Road, 400010, Chongqing, China.
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Wang S, Zhao S, Yu J, Gu Z, Zhang Y. Advances in Translational 3D Printing for Cartilage, Bone, and Osteochondral Tissue Engineering. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2022; 18:e2201869. [PMID: 35713246 DOI: 10.1002/smll.202201869] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 05/12/2022] [Indexed: 06/15/2023]
Abstract
The regeneration of 3D tissue constructs with clinically relevant sizes, structures, and hierarchical organizations for translational tissue engineering remains challenging. 3D printing, an additive manufacturing technique, has revolutionized the field of tissue engineering by fabricating biomimetic tissue constructs with precisely controlled composition, spatial distribution, and architecture that can replicate both biological and functional native tissues. Therefore, 3D printing is gaining increasing attention as a viable option to advance personalized therapy for various diseases by regenerating the desired tissues. This review outlines the recently developed 3D printing techniques for clinical translation and specifically summarizes the applications of these approaches for the regeneration of cartilage, bone, and osteochondral tissues. The current challenges and future perspectives of 3D printing technology are also discussed.
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Affiliation(s)
- Shenqiang Wang
- Zhejiang Provincial Key Laboratory for Advanced Drug Delivery Systems, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Sheng Zhao
- Zhejiang Provincial Key Laboratory for Advanced Drug Delivery Systems, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
| | - Jicheng Yu
- Zhejiang Provincial Key Laboratory for Advanced Drug Delivery Systems, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, 311121, China
| | - Zhen Gu
- Zhejiang Provincial Key Laboratory for Advanced Drug Delivery Systems, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
- Liangzhu Laboratory, Zhejiang University Medical Center, Hangzhou, 311121, China
- Department of General Surgery, Sir Run Run Hospital, School of Medicine, Zhejiang University, Hangzhou, 310016, China
- MOE Key Laboratory of Macromolecular Synthesis and Functionalization, Department of Polymer Science and Engineering, Zhejiang University, Hangzhou, 310027, China
- Jinhua Institute of Zhejiang University, Jinhua, 321299, China
| | - Yuqi Zhang
- Zhejiang Provincial Key Laboratory for Advanced Drug Delivery Systems, College of Pharmaceutical Sciences, Zhejiang University, Hangzhou, 310058, China
- Department of Burns and Wound Center, Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, 310009, China
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Zheng Y, Zhang Z, Wang D. Better vertebrae remodeling in pediatric spinal eosinophilic granuloma patients treated with kyphoplasty and short-term posterior instrumentation: A minimal two-year follow-up with historical controls. Front Pediatr 2022; 10:922844. [PMID: 36507140 PMCID: PMC9727175 DOI: 10.3389/fped.2022.922844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 11/07/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To assess the validity and safety of kyphoplasty combined with short-term posterior instrumentation to treat children with vertebrae plana due to eosinophilic granuloma (EG). PATIENTS AND METHODS Clinical data of EG patients, who received kyphoplasty and short-term instrumentation from March 2019 to March 2020, were retrospectively reviewed. The recovery of diseased vertebrae was assessed and compared with historical case data. RESULTS Nine patients with EG had received kyphoplasty and short-term posterior instrumentation. The mean age at initial treatment was 66.7 months old (range, 28-132 months). The average number of follow-up months was 26.7. (range, 24-30 months).Four and 5 cases presented with thoracic and lumbar vertebral destruction, respectively. Under Garg's classification, 7 and 2 cases were classified as Grade IIA and IIB, respectively. The average diseased vertebral heights at 1-year and 2-year after surgery were significantly higher than the preoperative heights. The average percentages of diseased vertebral heights to references at 1-year and 2-year after surgery were 72.0% and 86.0%, respectively. The average percentage of diseased vertebral heights to the references at 2-year after surgery was significantly higher than that of the historical cases at the same time. No minor or major adverse events were observed. CONCLUSIONS Transpedicular balloon kyphoplasty for the direct restoration of vertebrae plana seems feasible and safe in combination with short-term posterior instrumentation. Better short-time vertebrae remodeling was observed 2 years after surgery. Active surgical treatment is suggested for children who have vertebrae plana as a result of EG in order to maintain the ability to recover vertebral height.
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Affiliation(s)
- Yiming Zheng
- Department of Pediatric Orthopaedics, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Zhiqiang Zhang
- Department of Pediatric Orthopaedics, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
| | - Dahui Wang
- Department of Pediatric Orthopaedics, Children's Hospital of Fudan University, National Children's Medical Center, Shanghai, China
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Wang S, Wang B, Lan X, Xu Z, Huang H, Wang X, Shen S, Ma J. Application of a Personalized Finite Element Analysis and 3D-Printed Navigation Template in the Treatment of Femoral Neck Fracture with Cannulated Screw. J Med Biol Eng 2021. [DOI: 10.1007/s40846-021-00667-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Zhang Y, Weng Q, Gu Y, Chen J, Yang Y. Calcaneal fractures: 3D-printing model to assist spatial weaving of percutaneous screws versus conventional open fixation-a retrospective cohort study. INTERNATIONAL ORTHOPAEDICS 2021; 45:2337-2346. [PMID: 34117504 DOI: 10.1007/s00264-021-05094-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE This study compared the clinical effectiveness and wound complications of a three-dimensional model-assisted spatial weaving screw fixation (3D-SWSF) versus open reduction and internal fixation (ORIF) via an L-shaped extensile lateral approach for calcaneal fractures. METHODS This single-centre retrospective cohort study was conducted with two cohort groups in which patients with Sanders II and III calcaneal fractures underwent 3D-SWSF or conventional ORIF. The clinical outcome measures included operation duration, time to operation, wound complications, blood loss volume, hospital stays, American Orthopedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot score, and visual analog scale (VAS) score. The pre-operative, post-operative, and one-year follow-up Gissane's angle (GA), Böhler's angle (BA), height, and width and length of the calcaneal fractures were also compared between the two groups. RESULTS From Oct 2015 to Oct 2019, 31 patients received 3D-SWSF and 41 received conventional ORIF. A total of 11 (26.8%) patients in ORIF group had wound complications, compared with only two (6.5%) in 3D-SWSF group (p = 0.032). Operative time, blood loss, and hospital stay in 3D-SWSF group were lesser than those in ORIF group. The patients treated with 3D-SWSF had better AOFAS and VAS scores than those treated with ORIF at the last follow-up. The post-operative and one-year follow-up radiographic indexes as well as the GA, BA, length, width, and height of the calcaneal fractures were relatively comparable between the two groups. CONCLUSION Our study revealed that 3D-SWSF could effectively decrease the risk of wound complications, shorten operation time, reduce length of hospitalization, and improve post-operative rehabilitation.
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Affiliation(s)
- Yong Zhang
- Department of Foot and Ankle Surgery, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.,Department of Trauma Orthopedics Surgery, Ningbo No.6 Hospital, Medical School of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Qiuyan Weng
- Department of Neurology, The Affiliated Hospital of Medical School of Ningbo University, Ningbo, 315020, Zhejiang, China
| | - Yang Gu
- Department of Trauma Orthopedics Surgery, Ningbo No.6 Hospital, Medical School of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Jianming Chen
- Department of Trauma Orthopedics Surgery, Ningbo No.6 Hospital, Medical School of Ningbo University, Ningbo, 315040, Zhejiang, China
| | - Yunfeng Yang
- Department of Foot and Ankle Surgery, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, 200065, China.
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