۳D Printed Models of Periarticular Fractures of the Shoulder and Elbow Improve Surgical Decision Making in Orthopedic Trainees

Objectives: Periarticular fractures of the shoulder and elbow are spatially complex injuries that may be challenging to interpret on radiographs and advanced imaging. As three-dimensional (۳D) printing technology has become less expensive and more available, ۳D printed fracture models have gained attention for use in surgical preparation. In this study, we evaluated the eff ects of ۳D printed fracture models on orthopedic trainee surgical planning and injury understanding for injuries of the shoulder and elbow.Methods: Models of periarticular fractures of the shoulder and elbow were manufactured by ۳D printing at the medical school design lab. Eleven Orthopedic trainees viewed X-rays and computed tomography (CT) scans for each injury, and completed a preoperative questionnaires. They were then given access to the ۳D model of each injury, in addition to the previously viewed imaging. They again completed a preoperative plan and questionnaire. Preoperative plans were graded for feasibility by a preestablished template. Results were compared for each participant with and without the ۳D models.Results: Within all trainees and fractures, trainees were more likely to have feasible preoperative plans when given a ۳D model, compared to access to x-rays and CT scans alone (۷۴% vs. ۶۲%). In all cases where preoperative plans were changed after handling the ۳D models (۴۶/۷۷ changed, ۶۰%), they stayed static or improved in feasibility. Participants reported significantly improved understanding of injury anatomy (P<۰.۰۰۰۱), increased confidence in choosing operative positioning and surgical approaches (P<۰.۰۰۰۱), desired implants (P=۰.۰۱۱), and better conceptualization of how to perform fracture reduction (P=۰.۰۰۳۸).Conclusion: Orthopedic trainees benefit from ۳D printed fracture models when performing preoperative planning of complex periarticular shoulder and elbow injuries. Given the rarity and difficulty of these injuries, use of this technology could allow for shortened learning curves and improved surgical results in the field of orthopedic fracture care. Level of evidence: IV

کلیدواژه ها:

۳D printing ، Education ، Elbow fracture ، Orthopedic surgery ، Preoperative planning ، Proximal Humerus Fracture