Efficacy of two reduction methods in conjunction with 3-D–printed patient-specific pin guides for aligning simulated comminuted tibial fractures in cadaveric dogs

Abstract

OBJECTIVE To assess the feasibility and accuracy of using 2 methods for reduction and alignment of simulated comminuted diaphyseal tibial fractures in conjunction with 3-D–printed patient-specific pin guides. SAMPLE Paired pelvic limbs from 8 skeletally mature dogs weighing 20 to 35 kg. METHODS CT images of both tibiae were obtained, and 3-D 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 and alignment in conjunction with either a 3-D–printed reduction guide or a linear type 1A external fixator. Postreduction CT images were used to assess the accuracy of pin guide placement and the accuracy of fracture reduction and alignment. RESULTS The 3-D–printed guides were applied with acceptable ease. Guides for both groups were placed with minor but detectable deviations from the planned location (P = .01), but deviations were not significantly different between groups. Fracture reduction resulted in similar minor but detectable morphological differences from the intact tibiae (P = .01). In both groups, fracture reduction and alignment were within clinically acceptable parameters for fracture stabilization by means of minimally invasive plate osteosynthesis. CLINICAL RELEVANCE Virtual surgical planning and fabrication of patient-specific 3-D–printed pin guides have the potential to facilitate fracture reduction and alignment during use of minimally invasive plate osteosynthesis for fracture stabilization.