The Utility of 3-Dimensional Printing for Preoperative Plate Templating in Clavicular Fixation: A Cadaveric Study

Objectives: To investigate the effectiveness and reliability of 3-Dimensional (3D) printed models of the contralateral, unaffected clavicle to serve as templates of the affected side for preoperative planning. Method: Computed tomography scans of 18 embalmed cadavers (8 male and 10 female) were used to 3D-print mirror images of “unaffected” clavicles which were then used for the selection of a superior midshaft contoured plate. Various morphometric and goodness-of-fit measurements were taken of the 3D-printed clavicle and then the in-situ specimen. Statistical analysis was performed using two-tailed, unpaired t-tests with a p value < 0.05. Results: For 3D-printed models, 7/9 morphometric measurements differed significantly between males and females for both clavicles and in 1 additional measurement for right-sided clavicles. For in-situ specimens, 6/9 morphometric measurements differed significantly between male and female clavicles. When comparing the 3D-printed versus the corresponding in-situ clavicle, only 1/9 morphometric measurements differed significantly for both males and females and 1 additional measurement for each sex. The goodness-of-fit of the plate using the 3D-printed template for the in-situ specimen differed significantly only for males with a right clavicle mirrored to template for the left clavicle. Conclusions: Clavicular anatomic complexity and variance supports the need for many contoured plate options for adequate fixation. Preoperatively 3D-printed contralateral, mirrored clavicles for plate selection of midshaft clavicular fractures may reduce intraoperative time.