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Clinical outcomes of the use of 3D printing models in fracture management: a meta-analysis of randomized studies

  • Review Article
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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Purpose

The use of three-dimensional printing models in medical practice has been booming recently and its application to orthopedic surgery is gaining popularity. When treating fractures by open reduction and internal fixation, potential benefits have been associated with the use of 3D printing models. This review aims to quantitatively analyze the effectiveness of using 3D printing models in fracture management.

Materials and methods

A structured systematic review was conducted, and multiple databases were searched using a combination of terms related to 3D printing in fracture management. The literature search was limited from inception to Nov 2020. Only comparative randomized studies were accepted for inclusion. Any software or material using 3D printing versus no technological assistance was included. All types of fracture treated by open reduction and internal fixation were included. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) methodology was applied with the Joanna Briggs Institute’s critical appraisal tool used to assess the quality of the included studies. Quantitative analysis was performed.

Results

Based on 13 RCTs including 673 patients (325 and 348 in the 3D and control groups, respectively), the weighted effect size outcomes were as follows: (a) operative duration − 1.47 (95% CI = − 1.759 to − 1.182), (b) intraoperative blood loss − 1.41 (95% CI = − 1.792 to − 1.029), (c) fluoroscopy use − 1.25 (95% CI = − 1.637 to − 0.867), in favor of the 3D group. The weighted Odds ratio outcomes were: (a) overall good or excellent result 2.05 (95% CI = 1.119 to 3.845) and (b) anatomic fracture reduction 2.64 (95% CI = 1.150 to 6.051) in favor of the 3D group. The mean residual displacement and time to union showed no significant difference. The mean JBI appraisal tool score for the randomized studies was of 9, out of a maximum of 13.

Conclusions

When compared to the non-use of 3D technology for open reduction and internal fixation of fractures, the review demonstrated evidence that 3D printing yielded significantly better perioperative results. Further studies are needed to evaluate the effect of 3D printing on union and long-term function.

Level of evidence

I.

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Funding

No funding was received for conducting this study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, School of Medicine, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, Beirut, Lebanon

    Kaissar Yammine, Jimmy Daher & Chahine Assi

  2. Center for Evidence-Based Anatomy, Sport and Orthopedics Research, Beirut, Lebanon

    Kaissar Yammine, Jimmy Daher & Chahine Assi

  3. School of Medicine, Lebanese American University Medical Center-Rizk Hospital, Lebanese American University, Beirut, Lebanon

    Jad Karbala & Anthony Maalouf

Authors
  1. Kaissar Yammine
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  2. Jad Karbala
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  3. Anthony Maalouf
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  4. Jimmy Daher
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  5. Chahine Assi
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Correspondence to Kaissar Yammine.

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Yammine, K., Karbala, J., Maalouf, A. et al. Clinical outcomes of the use of 3D printing models in fracture management: a meta-analysis of randomized studies. Eur J Trauma Emerg Surg 48, 3479–3491 (2022). https://doi.org/10.1007/s00068-021-01758-1

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  • DOI: https://doi.org/10.1007/s00068-021-01758-1

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