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ORIGINAL ARTICLE
Year : 2016  |  Volume : 2  |  Issue : 3  |  Page : 113-119

Application of three-dimensional-printed navigation template in pediatric femoral neck fracture


1 Department of Pediatric Orthopaedics, Nanjing Children's Hospital Affiliated to Nanjing Medical University; Department of 3D Printing, Digital Medicine Insitute, Nanjing Medical University, Nanjing, Jiangsu, China
2 Department of 3D Printing, Digital Medicine Insitute; Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China

Correspondence Address:
Dr. Liming Wang
68 Changle Road, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu 210000
China
Dr. Yue Lou
72 Guangzhou Road,Nanjing Children's Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu 210000
China
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2226-8561.194699

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Background and Objectives: Pediatric femoral neck fracture is a serious and disabling injury that is prone to complications. This study examined the feasibility, accuracy, and efficiency of treating the fracture through a three-dimensional (3D)-printed navigation template that was used to guide placement of cannulated screws and locking compression-pediatric hip plates (LC-PHPs). Materials and Methods: Template-guided surgeries were carried out on nine children with femoral neck fracture from 1, 2012 to 12, 2014, and the resulting data were analyzed retrospectively. From preoperative computed tomography data, a 3D model of the proximal femur and a matching navigation template were created for guiding placement of cannulated screws or LC-PHP. Finally, the template-guided operation was performed, and the outcomes were compared to those from control patients undergoing the same surgery without navigation templates (n = 10). Results: The navigation templates were found to match the individual proximal femurs well. Two to three screws were accurately inserted in the femoral neck, and the end of the fracture was successfully stabilized. Implantation of the cannulated screws or LC-PHP took an average of 13.6 and 24.5 min, respectively, whereas intraoperative X-ray was used an average of 4.2 times for the former and 5.5 times for the latter. This was compared to 37.6 and 59.6 min, and 11.4 and 15.4 X-rays, for the controls. Postoperative X-ray showed a great reduction of the femoral neck fracture. Six- to twelve-month follow-ups indicated that the fracture had healed and the function of hip joint was excellent for seven of the children and good for two (Ratliff's criteria). Conclusions: Using 3D-printed guides, accurate and effective placement of cannulated screws and LC-PHPs is realized in the femoral neck. The method reduces operation time, intraoperative bleeding, radiation exposure, and iatrogenic damage to the vasculature, femoral neck, and epiphysis.


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