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Vet Comp Orthop Traumatol 2019; 32(02): 139-148
DOI: 10.1055/s-0039-1677751
Original Research
Georg Thieme Verlag KG Stuttgart · New York

Percutaneous Tibial Fracture Reduction Using Computed Tomography Imaging, Computer Modelling and 3D Printed Alignment Constructs: A Cadaveric Study

Albert C. Lynch
1   Santa Cruz Veterinary Hospital, Santa Cruz, California, United States
,
John A. Davies
2   Southern Oregon Veterinary Specialty Center, Central Point, Oregon, United States
› Institutsangaben
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Publikationsverlauf

14. Mai 2018

04. Dezember 2018

Publikationsdatum:
13. Februar 2019 (online)

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Abstract

Objective The main aim of this study was to evaluate a percutaneous method of bone alignment using a diaphyseal tibial fracture model.

Materials and Methods Mid-shaft diaphyseal fractures were created in 12 large-breed canine tibiae. Interaction pins were inserted into the proximal and distal bone segments. Computed tomography scans of the fractured tibiae and pins were imported into three-dimensional (3D) modelling software and the fractures were virtually reduced. A multi-component 3D printed alignment jig was created that encompassed the pins in their aligned configuration. Orthogonal radiographs were taken after alignment jig application. Intact and post-alignment tibial lengths and joint angles were compared. Rotational alignment was subjectively evaluated.

Results Post-alignment tibial lengths differed on the mediolateral and craniocaudal radiographs by an average of 1.55 and 1.43% respectively. Post-alignment mechanical medial proximal tibial angle, mechanical medial distal tibial angle and mechanical caudal proximal tibial angle had an average difference of 1.67°, 1.92° and 2.17° respectively. Differences in tibial length and joint angles were not significant (p > 0.05).

Clinical Significance While in vivo evaluation is necessary, this technique to align diaphyseal fractures percutaneously using computer modelling and 3D printing is technically feasible and may facilitate the clinical use of minimally invasive osteosynthesis techniques.

Keywords

tibia - three-dimensional printing - fracture alignment - canine - minimally invasive osteosynthesis

Authors' Contribution

Both authors contributed to conception of study, study design, acquisition of data and data analysis and interpretation. Both authors also drafted, revised and approved the submitted manuscript.


Note

The results of this report have been presented at the 2017 American College of Veterinary Surgeons (ACVS) Surgery Summit held at Indianapolis, IN, on October 14, 2017 and Veterinary Orthopedic Society (VOS) Conference held at Snowmass Village, CO on March 10, 2018.