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Erschienen in: European Journal of Trauma and Emergency Surgery 5/2022

24.08.2020 | Original Article

A new universal 3D-printable device to prevent excessive drilling in orthopedic surgery

verfasst von: Joan Ferràs-Tarragó, Pablo Jordà-Gómez, Juan Català-de-las-Marinas, Juan Manuel Antequera-Cano, Mariano Barrés-Carsí

Erschienen in: European Journal of Trauma and Emergency Surgery | Ausgabe 5/2022

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Abstract

Introduction

The occurrence of vascular injury during drilling is a rare but severe complication. Unfortunately, drilling protection systems are not available in all hospitals. Thanks to the development of 3D printing in recent years, sharing devices and materials to solve surgical problems has become easy and inexpensive. The objective of our work is to evaluate a universal, freely accessible, 3D-printable drilling protection device.

Materials and methods

A prospective, randomized, and triple-blind evaluation of excess drilling was evaluated in expert surgeons and resident surgeons without the use of the protection device. Subsequently, excess drilling was assessed using the device in both groups. The differences in drilling lengths between both groups with and without the device were analyzed to establish the reduction of excess drilling in both groups.

Results

The drilling in the expert surgeon without device group was 3.03 mm (SD 1.69 95% CI 2.40–3.66 p value = 9.89e−11), while the resident surgeon with device group performed excess drilling of 1.76 mm (SD 0.89 CI 95% 1.43–2.10). Results showed better results in the resident surgeon with device group than in the expert surgeons with device group (p value ˂ 0.01). The device improved drilling in both resident surgeons (5.77 mm) and expert surgeons (1.17 mm).

Conclusions

The device improves drilling in both expert surgeons and resident surgeons, showing greater benefits in the latter. The device is printable with any 3D printer, making it universally accessible, inexpensive, and effective, allowing expert surgeons to improve precision in high-risk situations and resident surgeons to improve their technique without increasing risk to the patient.
Literatur
1.
Zurück zum Zitat Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4(1):46–56.CrossRef Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4(1):46–56.CrossRef
2.
Zurück zum Zitat Kani KK, Porrino JA, Mulcahy H, Chew FS. Fragility fractures of the proximal femur: review and update for radiologists. Skeletal Radiol. 2019;48(1):29–45.CrossRef Kani KK, Porrino JA, Mulcahy H, Chew FS. Fragility fractures of the proximal femur: review and update for radiologists. Skeletal Radiol. 2019;48(1):29–45.CrossRef
3.
Zurück zum Zitat Bhandari M, Swiontkowski M. Management of acute hip fracture. N Engl J Med. 2017;377(21):2053–62.CrossRef Bhandari M, Swiontkowski M. Management of acute hip fracture. N Engl J Med. 2017;377(21):2053–62.CrossRef
4.
Zurück zum Zitat Court-Brown CM, Duckworth AD, Clement ND, McQueen MM. Fractures in older adults. A view of the future? Injury. 2018;49(12):2161–6.CrossRef Court-Brown CM, Duckworth AD, Clement ND, McQueen MM. Fractures in older adults. A view of the future? Injury. 2018;49(12):2161–6.CrossRef
5.
Zurück zum Zitat Rosengren BE, Karlsson MK. The annual number of hip fractures in Sweden will double from year 2002 to 2050: projections based on local and nationwide data. Acta Orthop. 2014;85(3):234–7.CrossRef Rosengren BE, Karlsson MK. The annual number of hip fractures in Sweden will double from year 2002 to 2050: projections based on local and nationwide data. Acta Orthop. 2014;85(3):234–7.CrossRef
6.
Zurück zum Zitat LeBlanc KE, Muncie HLJ, LeBlanc LL. Hip fracture: diagnosis, treatment, and secondary prevention. Am Fam Physician. 2014;89(12):945–51.PubMed LeBlanc KE, Muncie HLJ, LeBlanc LL. Hip fracture: diagnosis, treatment, and secondary prevention. Am Fam Physician. 2014;89(12):945–51.PubMed
7.
Zurück zum Zitat Potera C. Seniors need hip fracture surgery within 24 hours. Am J Nurs. 2018;118(3):14.CrossRef Potera C. Seniors need hip fracture surgery within 24 hours. Am J Nurs. 2018;118(3):14.CrossRef
8.
Zurück zum Zitat Haviari S. Wait time for hip fracture surgery and mortality. JAMA. 2018;319(21):2234.CrossRef Haviari S. Wait time for hip fracture surgery and mortality. JAMA. 2018;319(21):2234.CrossRef
9.
Zurück zum Zitat Roberts KC, Brox WT, Jevsevar DS, Sevarino K. Management of hip fractures in the elderly. J Am Acad Orthop Surg. 2015;23(2):131–7.CrossRef Roberts KC, Brox WT, Jevsevar DS, Sevarino K. Management of hip fractures in the elderly. J Am Acad Orthop Surg. 2015;23(2):131–7.CrossRef
10.
Zurück zum Zitat Chlebeck JD, Birch CE, Blankstein M, Kristiansen T, Bartlett CS, Schottel PC. Nonoperative geriatric hip fracture treatment is associated with increased mortality: a matched cohort Study. J Orthop Trauma. 2019;33(7):346–50.CrossRef Chlebeck JD, Birch CE, Blankstein M, Kristiansen T, Bartlett CS, Schottel PC. Nonoperative geriatric hip fracture treatment is associated with increased mortality: a matched cohort Study. J Orthop Trauma. 2019;33(7):346–50.CrossRef
11.
Zurück zum Zitat Carulli C, Piacentini F, Paoli T, Civinini R, Innocenti M. A comparison of two fixation methods for femoral trochanteric fractures: a new generation intramedullary system vs sliding hip screw. Clin Cases Miner Bone Metab Off J Ital Soc Osteoporos Miner Metab Skelet Dis. 2017;14(1):40–7. Carulli C, Piacentini F, Paoli T, Civinini R, Innocenti M. A comparison of two fixation methods for femoral trochanteric fractures: a new generation intramedullary system vs sliding hip screw. Clin Cases Miner Bone Metab Off J Ital Soc Osteoporos Miner Metab Skelet Dis. 2017;14(1):40–7.
12.
Zurück zum Zitat Stockton DJ, Dua K, O’Brien PJ, Pollak AN, Hoshino CM, Slobogean GP. Failure patterns of femoral neck fracture fixation in young patients. Orthopedics. 2019;42(4):e376–e380380.CrossRef Stockton DJ, Dua K, O’Brien PJ, Pollak AN, Hoshino CM, Slobogean GP. Failure patterns of femoral neck fracture fixation in young patients. Orthopedics. 2019;42(4):e376–e380380.CrossRef
13.
Zurück zum Zitat Chughtai M, Khlopas A, Mont MA. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial. Lancet Lond Engl. 2017;389(10078):1519–27.CrossRef Chughtai M, Khlopas A, Mont MA. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial. Lancet Lond Engl. 2017;389(10078):1519–27.CrossRef
14.
Zurück zum Zitat Zhang B-F, Cong Y-X, Wang P-F, Huang H, Wang H, Zhuang Y. Deep femoral artery branch pseudoaneurysm formation and injury after hip fracture surgery: a case series and a literature review. Medicine (Baltimore). 2018;97(6):e9872.CrossRef Zhang B-F, Cong Y-X, Wang P-F, Huang H, Wang H, Zhuang Y. Deep femoral artery branch pseudoaneurysm formation and injury after hip fracture surgery: a case series and a literature review. Medicine (Baltimore). 2018;97(6):e9872.CrossRef
15.
Zurück zum Zitat Barquet A, Gelink A, Giannoudis PV. Proximal femoral fractures and vascular injuries in adults: incidence, aetiology and outcomes. Injury. 2015;46(12):2297–313.CrossRef Barquet A, Gelink A, Giannoudis PV. Proximal femoral fractures and vascular injuries in adults: incidence, aetiology and outcomes. Injury. 2015;46(12):2297–313.CrossRef
16.
Zurück zum Zitat Neubauer T, Grechenig S, Leitner L, Auffarth A, Plecko M. Vascular complications in plating of the proximal femur: review. Arch Orthop Trauma Surg. 2016;136(4):539–51.CrossRef Neubauer T, Grechenig S, Leitner L, Auffarth A, Plecko M. Vascular complications in plating of the proximal femur: review. Arch Orthop Trauma Surg. 2016;136(4):539–51.CrossRef
17.
Zurück zum Zitat Tomčovčík L, Kováč P, Daňo J, Čuha R. Late laceration of the superficial femoral artery by an intertrochanteric fracture fragment. Hip Int J Clin Exp Res Hip Pathol Ther. 2011;21(2):273–5. Tomčovčík L, Kováč P, Daňo J, Čuha R. Late laceration of the superficial femoral artery by an intertrochanteric fracture fragment. Hip Int J Clin Exp Res Hip Pathol Ther. 2011;21(2):273–5.
18.
Zurück zum Zitat Clement H, Heidari N, Grechenig W, Weinberg AM, Pichler W. Drilling, not a benign procedure: laboratory simulation of true drilling depth. Injury. 2012;43(6):950–2.CrossRef Clement H, Heidari N, Grechenig W, Weinberg AM, Pichler W. Drilling, not a benign procedure: laboratory simulation of true drilling depth. Injury. 2012;43(6):950–2.CrossRef
19.
Zurück zum Zitat McIntosh AL. Surgical treatment of adolescent clavicle fractures: results and complications. J Pediatr Orthop. 2016;36(Suppl 1):S41–43.CrossRef McIntosh AL. Surgical treatment of adolescent clavicle fractures: results and complications. J Pediatr Orthop. 2016;36(Suppl 1):S41–43.CrossRef
20.
Zurück zum Zitat Bernhoff K, Björck M. Iatrogenic popliteal artery injury in non arthroplasty knee surgery. Bone Jt J. 2015;97-B(2):192–6.CrossRef Bernhoff K, Björck M. Iatrogenic popliteal artery injury in non arthroplasty knee surgery. Bone Jt J. 2015;97-B(2):192–6.CrossRef
21.
Zurück zum Zitat Wang X-Z, Shi Z, Lu Q-L, Xie W, Chen L, Li X-G, et al. Treatment of old acetabular posterior wall fracture with 3D printing combined with composite plate internal fixation. Zhongguo Gu Shang China J Orthop Traumatol. 2019;32(5):395–400. Wang X-Z, Shi Z, Lu Q-L, Xie W, Chen L, Li X-G, et al. Treatment of old acetabular posterior wall fracture with 3D printing combined with composite plate internal fixation. Zhongguo Gu Shang China J Orthop Traumatol. 2019;32(5):395–400.
22.
Zurück zum Zitat You W, Liu LJ, Chen HX, Xiong JY, Wang DM, Huang JH, et al. Application of 3D printing technology on the treatment of complex proximal humeral fractures (Neer3-part and 4-part) in old people. Orthop Traumatol Surg Res OTSR. 2016;102(7):897–903.CrossRef You W, Liu LJ, Chen HX, Xiong JY, Wang DM, Huang JH, et al. Application of 3D printing technology on the treatment of complex proximal humeral fractures (Neer3-part and 4-part) in old people. Orthop Traumatol Surg Res OTSR. 2016;102(7):897–903.CrossRef
23.
Zurück zum Zitat Tomaževič M, Kristan A, Kamath AF, Cimerman M. 3D printing of implants for patient-specific acetabular fracture fixation: an experimental study. Eur J Trauma Emerg Surg Off Publ Eur Trauma Soc. 2019 Tomaževič M, Kristan A, Kamath AF, Cimerman M. 3D printing of implants for patient-specific acetabular fracture fixation: an experimental study. Eur J Trauma Emerg Surg Off Publ Eur Trauma Soc. 2019
Metadaten
Titel
A new universal 3D-printable device to prevent excessive drilling in orthopedic surgery
verfasst von
Joan Ferràs-Tarragó
Pablo Jordà-Gómez
Juan Català-de-las-Marinas
Juan Manuel Antequera-Cano
Mariano Barrés-Carsí
Publikationsdatum
24.08.2020
Verlag
Springer Berlin Heidelberg
Erschienen in
European Journal of Trauma and Emergency Surgery / Ausgabe 5/2022
Print ISSN: 1863-9933
Elektronische ISSN: 1863-9941
DOI
https://doi.org/10.1007/s00068-020-01465-3

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