Comparative use of the computer-aided angiography and rapid prototyping technology versus conventional imaging in the management of the Tile C pelvic fractures

Int Orthop. 2016 Jan;40(1):161-6. doi: 10.1007/s00264-015-2800-0. Epub 2015 May 21.

Abstract

Introduction: Computed tomography (CT) scan with three-dimensional (3D) reconstruction has been used to evaluate complex fractures in pre-operative planning. In this study, rapid prototyping of a life-size model based on 3D reconstructions including bone and vessel was applied to evaluate the feasibility and prospect of these new technologies in surgical therapy of Tile C pelvic fractures by observing intra- and perioperative outcomes.

Materials and methods: The authors conducted a retrospective study on a group of 157 consecutive patients with Tile C pelvic fractures. Seventy-six patients were treated with conventional pre-operative preparation (A group) and 81 patients were treated with the help of computer-aided angiography and rapid prototyping technology (B group). Assessment of the two groups considered the following perioperative parameters: length of surgical procedure, intra-operative complications, intra- and postoperative blood loss, postoperative pain, postoperative nausea and vomiting (PONV), length of stay, and type of discharge.

Results: The two groups were homogeneous when compared in relation to mean age, sex, body weight, injury severity score, associated injuries and pelvic fracture severity score. Group B was performed in less time (105 ± 19 minutes vs. 122 ± 23 minutes) and blood loss (31.0 ± 8.2 g/L vs. 36.2 ± 7.4 g/L) compared with group A. Patients in group B experienced less pain (2.5 ± 2.3 NRS score vs. 2.8 ± 2.0 NRS score), and PONV affected only 8 % versus 10 % of cases. Times to discharge were shorter (7.8 ± 2.0 days vs. 10.2 ± 3.1 days) in group B, and most of patients were discharged to home.

Conclusions: In our study, patients of Tile C pelvic fractures treated with computer-aided angiography and rapid prototyping technology had a better perioperative outcome than patients treated with conventional pre-operative preparation. Further studies are necessary to investigate the advantages in terms of clinical results in the short and long run.

Keywords: Angiography; Computer; Pelvic fracture; Perioperative outcome; Rapid prototyping.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Angiography / methods*
  • Female
  • Fractures, Bone / diagnostic imaging*
  • Fractures, Bone / surgery*
  • Humans
  • Imaging, Three-Dimensional / methods
  • Injury Severity Score
  • Intraoperative Complications
  • Length of Stay
  • Male
  • Middle Aged
  • Orthopedic Procedures / adverse effects
  • Orthopedic Procedures / methods*
  • Pelvic Bones / diagnostic imaging
  • Pelvic Bones / injuries*
  • Postoperative Complications
  • Retrospective Studies
  • Surgery, Computer-Assisted / adverse effects
  • Surgery, Computer-Assisted / methods*
  • Tomography, X-Ray Computed / methods*