After surgical treatment of comminuted diaphyseal femoral and tibial fractures, relevant malalignment, especially rotational errors occur in up to 40–50%. This either results in a poor clinical outcome or requires revision surgery. This study aims to evaluate the accuracy of reduction if surgery is supported by 3D guides planned and printed at the point of care. Ten porcine legs underwent computed tomography (CT) and 3D models of femur and tibia were built. Reduction guides were virtually constructed and fitted to the proximal and distal metaphysis. The guides were 3D printed using medically approved resin. Femoral and tibial comminuted diaphyseal fractures were simulated and subsequently reduced using the 3D guides. Postoperative 3D bone models were reconstructed to compare the accuracy to the preoperative planning. Femoral reduction showed a mean deviation ± SD from the plan of 1.0 mm ± 0.9 mm for length, 0.9° ± 0.7° for varus/valgus, 1.2° ± 0.9° for procurvatum/recurvatum and 2.0° ± 1.7° for rotation. Analysis of the tibial reduction revealed a mean deviation ± SD of 2.4 mm ± 1.6 mm for length, 1.0° ± 0.6° for varus/valgus, 1.3° ± 1.4° for procurvatum/recurvatum and 2.9° ± 2.2° for rotation. This study shows high accuracy of reduction with 3D guides planned and printed at the point of care. Applied to a clinical setting, this technique has the potential to avoid malreduction and consecutive revision surgery in comminuted diaphyseal fractures. Basic Science.

中文翻译：

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在护理点计划和打印的 3D 打印骨折复位指南显示出高精度 - 猪可行性研究

粉碎性股骨和胫骨骨干骨折的手术治疗后，相关的对线不良，特别是旋转错误发生率高达 40-50%。这要么导致不良的临床结果，要么需要进行翻修手术。本研究旨在评估在护理点计划和打印的 3D 指南支持手术的情况下减少的准确性。十只猪腿接受了计算机断层扫描 (CT) 并建立了股骨和胫骨的 3D 模型。复位导板实际上是构建并适合近端和远端干骺端。这些指南是使用医学认可的树脂 3D 打印的。模拟股骨和胫骨粉碎性骨干骨折，随后使用 3D 导板进行复位。重建术后 3D 骨骼模型，以将准确性与术前规划进行比较。股骨减少显示与计划的平均偏差 ± SD，长度为 1.0 mm ± 0.9 mm，内翻/外翻为 0.9° ± 0.7°，前弯/反曲为 1.2° ± 0.9°，旋转为 2.0° ± 1.7°。胫骨复位分析显示，长度的平均偏差 ± SD 为 2.4 mm ± 1.6 mm，内翻/外翻为 1.0° ± 0.6°，前弯/反曲为 1.3° ± 1.4°，旋转为 2.9° ± 2.2°。这项研究显示了在护理点计划和打印的 3D 指南的高精度减少。应用于临床环境，该技术有可能避免粉碎性骨干骨折的复位不良和连续翻修手术。基础科学。胫骨复位分析显示，长度的平均偏差 ± SD 为 2.4 mm ± 1.6 mm，内翻/外翻为 1.0° ± 0.6°，前弯/反曲为 1.3° ± 1.4°，旋转为 2.9° ± 2.2°。这项研究显示了在护理点计划和打印的 3D 指南的高精度减少。应用于临床环境，该技术有可能避免粉碎性骨干骨折的复位不良和连续翻修手术。基础科学。胫骨复位分析显示，长度的平均偏差 ± SD 为 2.4 mm ± 1.6 mm，内翻/外翻为 1.0° ± 0.6°，前弯/反曲为 1.3° ± 1.4°，旋转为 2.9° ± 2.2°。这项研究显示了在护理点计划和打印的 3D 指南的高精度减少。应用于临床环境，该技术有可能避免粉碎性骨干骨折的复位不良和连续翻修手术。基础科学。这种技术有可能避免粉碎性骨干骨折的复位不良和连续翻修手术。基础科学。这种技术有可能避免粉碎性骨干骨折的复位不良和连续翻修手术。基础科学。