Research Article: Clinical efficacy and biomechanical analysis of 3D-printed guide plate–assisted cannulated screw fixation compared with conventional fixation in complex acetabular fractures
Abstract:
Optimal fixation for pelvic and acetabular fractures remains challenging due to competing demands for stability and minimally invasive surgery. This study combined finite element (FE) modeling and a retrospective clinical analysis to compare three fixation strategies.
A three-dimensional FE model of a representative both-column acetabular fracture was constructed to compare cannulated screw-only, plate-only, and combined cannulated screw–plate fixation under simulated standing and sitting conditions. Clinically, patients with acetabular fractures treated between November 2021 and May 2023 were retrospectively grouped into 3D-printed guide plate–assisted cannulated screw plus plate ( n =?8), conventional cannulated screw plus plate ( n =?14), and plate-only fixation ( n =?12). Perioperative outcomes, postoperative complications, and 3-month hip function were analyzed with multivariable adjustment.
FE analysis showed higher stress and displacement under sitting than standing across all constructs, with combined cannulated screw–plate fixation providing better fracture-line displacement control than screw-only fixation, particularly under sitting conditions. Clinically, after multivariable adjustment, the 3D-printed guide group had significantly shorter operative time than the plate-only group and the conventional screw plus plate group (?56.15?min, P =?0.048; ?68.46?min, P =?0.031, respectively), lower intraoperative blood loss than the plate-only group (?575.48?mL, P =?0.001), and shorter incision length than the plate-only group (?7.94?cm, P =?0.004). Both the 3D-printed guide group and the conventional screw plus plate group showed significantly lower total hospitalization costs than the plate-only group (?39,944.29 RMB, P =?0.040; ?32,527.55 RMB, P =?0.048, respectively). No significant adjusted differences were observed in complication risk, 3-month hip function, or hospital length of stay.
Combined cannulated screw–plate fixation provides superior biomechanical stability for complex acetabular fractures, while patient-specific 3D-printed guide plate significantly improve perioperative efficiency without compromising short-term safety or functional recovery.
Introduction:
Optimal fixation for pelvic and acetabular fractures remains challenging due to competing demands for stability and minimally invasive surgery. This study combined finite element (FE) modeling and a retrospective clinical analysis to compare three fixation strategies.
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