PRELIMINARY APPLICATION OF THREE-DIMENSIONAL PRINTING PERSONALIZED EXTERNAL FIXATOR IN SERIOUS TIBIOFIBULA FRACTURES_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HUANGMinqiang ^1,2 ,  DINGHuanwen ¹ , HUANGMiaojun ³ , WANGHong ¹ , TENGQiang ^1,2

1. Department of Bone and Joint Disease, Guangzhou General Hospital of Guangzhou Military, Guangzhou Guangdong, 510010, P. R. China;
2. Graduate College, Traditional Chinese Medicine University of Guangzhou;
Synergy Innovation Research Institute of South China;

Corresponding?author：

DINGHuanwen, Email: dhuanwen123@aliyun.com

Keywords：

Three-dimensional printing; Tibiofibula comminuted fracture; External fixator; Digital design; Individual design

DOI：

10.7507/1002-1892.20160032

Video：

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Objective To explore a new method of treating serious tibiofibula comminuted fracture by using three-dimensional (3-D) printing personalized external fixator. Methods In April 2015, a male patient (aged 18 years with a height of 171 cm and a weight of 67 kg) with left tibiofibula comminuted fracture was included in the study. Computer-assisted reduction technique combined with 3-D printing was used to develop a customised personalized external fixator for fracture reduction. The effectiveness was observed. Results The operation time was about 10 minutes without fluoroscopy, and successful reduction was obtained. The patient had equal limb length after operation. X-ray films showed that the posterior angulation of distal fracture was corrected 37°, and the eversion angle was corrected 4°. The tibial fractures had good paraposition or alignment, and the lower limb force line was corrected completely. No new fracture displacement occurred. The clinical healing time of fracture was 3.5 months and the bone union was achieved after 8 months. The function of affected limb recovered well after operation. Conclusion A personalized external fixator for serious tibiofibula comminuted fracture reduction made by 3-D printing technique has the merits of easy manipulation, high individuation, accurate reduction, stable fixation, and no need of fluoroscopy.

Citation： HUANGMinqiang, DINGHuanwen, HUANGMiaojun, WANGHong, TENGQiang. PRELIMINARY APPLICATION OF THREE-DIMENSIONAL PRINTING PERSONALIZED EXTERNAL FIXATOR IN SERIOUS TIBIOFIBULA FRACTURES. Chinese Journal of Reparative and Reconstructive Surgery, 2016, 30(2): 156-160. doi: 10.7507/1002-1892.20160032 Copy

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2.	葉國強, 傅國, 戚劍. 一期封閉式負壓引流聯合雙蒂滑行皮瓣治療開放性脛腓骨骨折伴脛前軟組織缺損. 中國修復重建外科雜志, 2015, 29(8):955-958.
3.	劉立強, 熊明月, 王坤正, 等. HoffmannⅡ外固定架治療脛腓骨粉碎性骨折的療效觀察. 中國骨與關節損傷雜志, 2014, 29(6):95-96.
4.	徐佳明, 艾自勝, 張長青. 脛腓骨骨折固定物與固定方式的研究進展. 中國組織工程研究, 2013, 17(4):663-671.
5.	楊佐明, 劉曉明, 戴士峰, 等. 脛腓骨骨折術后感染的治療分析. 中國修復重建外科雜志, 2011, 25(9):1151-1152.
6.	丁煥文, 易燦, 涂強, 等. 計算機輔助骨盆腫瘤精確切除和功能重建. 中國修復重建外科雜志, 2011, 25(10):1218-1223.
7.	Lei T, Xie L, Tu W, et al. Development of a finite element model for blast injuries to the pig mandible and a preliminary biomechanical analysis. J Trauma Acute Care Surg, 2012, 73(4):902-907.
8.	唐通鳴, 陸燕, 李志揚, 等. 新型3D打印材料ABS的制備及性能研究. 現代化工, 2015, 35(7):50-52.
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10.	張功林, 葛寶豐. 外固定支架治療骨折研究進展. 國際骨科學雜志, 2011, 32(2):99-101.
11.	王濤, 胡一博, 宋昌才, 等. 計算機輔助Taylor三維空間外固定架治療下肢骨干骨折的初步應用. 中國矯形外科雜志, 2015, 23(16):1518-1520.
12.	Koo TK, Chao EY, Mak AF. Development and validation of a new approach for computer-aided long bone fracture reduction using unilateral external fixator. J Biomech, 2006, 39(11):2104-2112.
13.	Bose S, Vahabzadeh S, Bandyopadhyay A. Bone tissue engineering using 3D printing. Mater Today, 2013, 16(12):496-504.
14.	鮑立杰, 張志平, 吳培斌. 3D打印技術在骨科的研究及應用進展. 中國矯形外科雜志, 2015, 23(4):325-327.
15.	TonyK, Jake Evill. 3D打印骨骼固定支架. 設計, 2013, (9):26.
16.	黃若景. 3D打印計算機輔助設計小夾板外骨骼系統的研究. 廣州:廣州中醫藥大學, 2015.
17.	Qiao F, Li D, Jin Z, et al. Application of 3D printed customized external fixator in fracture reduction. Injury, 2015, 46(6):1150-1155.
18.	李暉. Boomer 281臺車拐臂靜力學結構強度有限元分析. 現代礦業, 2014, (8):160-163.
19.	吳繼明, 楊俊生, 李穎, 等. 四種外固定支架的力學性能對照研究. 中國骨與關節損傷雜志, 2009, 24(11):1016-1017.
20.	張偉, 宋世鋒, 劉立柱, 等. 單臂外固定架治療GustiloⅢ型脛骨骨折的初步臨床分析. 中國矯形外科雜志, 2015, 23(8):766-768.
21.	李國興. 兩種固定方式治療脛骨骨折臨床療效分析. 中國現代藥物應用, 2014, 8(1):98-99.
22.	吳超, 譚倫, 林旭, 等. 3D打印個體化矢狀曲度模棒及椎弓根螺釘導航模板在胸腰椎骨折脫位術中的應用. 中國修復重建外科雜志, 2015, 29(11):1381-1388.
23.	陳校明, 劉忠, 唐新橋, 等. 鑲嵌式外固定器加壓固定不植骨治療肥大性骨不連. 創傷外科雜志, 2015, 17(3):264.

1. ?Ashraf MO, Jones HM, Kanvinde R. Acute traumatic fracture dislocation of proximal tibiofibular joint:case report and literature review. Injury, 2015, 46(7):1400-1402.
2. 葉國強, 傅國, 戚劍. 一期封閉式負壓引流聯合雙蒂滑行皮瓣治療開放性脛腓骨骨折伴脛前軟組織缺損. 中國修復重建外科雜志, 2015, 29(8):955-958.
3. 劉立強, 熊明月, 王坤正, 等. HoffmannⅡ外固定架治療脛腓骨粉碎性骨折的療效觀察. 中國骨與關節損傷雜志, 2014, 29(6):95-96.
4. 徐佳明, 艾自勝, 張長青. 脛腓骨骨折固定物與固定方式的研究進展. 中國組織工程研究, 2013, 17(4):663-671.
5. 楊佐明, 劉曉明, 戴士峰, 等. 脛腓骨骨折術后感染的治療分析. 中國修復重建外科雜志, 2011, 25(9):1151-1152.
6. 丁煥文, 易燦, 涂強, 等. 計算機輔助骨盆腫瘤精確切除和功能重建. 中國修復重建外科雜志, 2011, 25(10):1218-1223.
7. Lei T, Xie L, Tu W, et al. Development of a finite element model for blast injuries to the pig mandible and a preliminary biomechanical analysis. J Trauma Acute Care Surg, 2012, 73(4):902-907.
8. 唐通鳴, 陸燕, 李志揚, 等. 新型3D打印材料ABS的制備及性能研究. 現代化工, 2015, 35(7):50-52.
9. 張云波, 喬雯鈺, 張鑫鑫, 等. 3D打印用高分子材料的研究與應用進展. 上海塑料, 2015, (1):1-5.
10. 張功林, 葛寶豐. 外固定支架治療骨折研究進展. 國際骨科學雜志, 2011, 32(2):99-101.
11. 王濤, 胡一博, 宋昌才, 等. 計算機輔助Taylor三維空間外固定架治療下肢骨干骨折的初步應用. 中國矯形外科雜志, 2015, 23(16):1518-1520.
12. Koo TK, Chao EY, Mak AF. Development and validation of a new approach for computer-aided long bone fracture reduction using unilateral external fixator. J Biomech, 2006, 39(11):2104-2112.
13. Bose S, Vahabzadeh S, Bandyopadhyay A. Bone tissue engineering using 3D printing. Mater Today, 2013, 16(12):496-504.
14. 鮑立杰, 張志平, 吳培斌. 3D打印技術在骨科的研究及應用進展. 中國矯形外科雜志, 2015, 23(4):325-327.
15. TonyK, Jake Evill. 3D打印骨骼固定支架. 設計, 2013, (9):26.
16. 黃若景. 3D打印計算機輔助設計小夾板外骨骼系統的研究. 廣州:廣州中醫藥大學, 2015.
17. Qiao F, Li D, Jin Z, et al. Application of 3D printed customized external fixator in fracture reduction. Injury, 2015, 46(6):1150-1155.
18. 李暉. Boomer 281臺車拐臂靜力學結構強度有限元分析. 現代礦業, 2014, (8):160-163.
19. 吳繼明, 楊俊生, 李穎, 等. 四種外固定支架的力學性能對照研究. 中國骨與關節損傷雜志, 2009, 24(11):1016-1017.
20. 張偉, 宋世鋒, 劉立柱, 等. 單臂外固定架治療GustiloⅢ型脛骨骨折的初步臨床分析. 中國矯形外科雜志, 2015, 23(8):766-768.
21. 李國興. 兩種固定方式治療脛骨骨折臨床療效分析. 中國現代藥物應用, 2014, 8(1):98-99.
22. 吳超, 譚倫, 林旭, 等. 3D打印個體化矢狀曲度模棒及椎弓根螺釘導航模板在胸腰椎骨折脫位術中的應用. 中國修復重建外科雜志, 2015, 29(11):1381-1388.
23. 陳校明, 劉忠, 唐新橋, 等. 鑲嵌式外固定器加壓固定不植骨治療肥大性骨不連. 創傷外科雜志, 2015, 17(3):264.

Chinese Journal of Reparative and Reconstructive Surgery

PRELIMINARY APPLICATION OF THREE-DIMENSIONAL PRINTING PERSONALIZED EXTERNAL FIXATOR IN SERIOUS TIBIOFIBULA FRACTURES

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