Application of 3D Printing in the Surgical Planning of Trimalleolar Fracture and Doctor-Patient Communication

Abstract

To evaluate the effect of 3D printing in treating trimalleolar fractures and its roles in physician-patient communication, thirty patients with trimalleolar fractures were randomly divided into the 3D printing assisted-design operation group (Group A) and the no-3D printing assisted-design group (Group B). In Group A, 3D printing was used by the surgeons to produce a prototype of the actual fracture to guide the surgical treatment. All patients underwent open reduction and internal fixation. A questionnaire was designed for doctors and patients to verify the verisimilitude and effectiveness of the 3D-printed prototype. Meanwhile, the operation time and the intraoperative blood loss were compared between the two groups. The fracture prototypes were accurately printed, and the average overall score of the verisimilitude and effectiveness of the 3D-printed prototypes was relatively high. Both the operation time and the intraoperative blood loss in Group A were less than those in Group B (P < 0.05). Patient satisfaction using the 3D-printed prototype and the communication score were 9.3 ± 0.6 points. A 3D-printed prototype can faithfully reflect the anatomy of the fracture site; it can effectively help the doctors plan the operation and represent an effective tool for physician-patient communication.

Figures

Figure 1

A 37-year-old female had a left trimalleolar fracture and underwent open reduction and internal fixation. 3D prototype was designed and printed by the authors; it was used for preoperative planning: (a) preoperative X-ray film; (b) postoperative X-ray film; (c) preoperative three-dimensional reconstruction by Mimics software; (d, e) digital fracture prototype and the corresponding 3D-printed 1 : 1 solid prototype.