3D printing and three column concept in surgical treatment of tibial plateau fracture

The aim of study was to evaluate the efficacy of the use of three-dimensional (3D) printing model for preoperative planning in treatment of tibial plateau fracture. Besides, we also investigated the effect of 3D printing technology on the communication between doctors and patients. Thirty-three patients with tibial plateau fractures were enrolled in the study from March 2022 to July 2023. A 3D digital model of each tibial plateau fracture was constructed, and the individual model was exported to a 3D printer for the construction of a full solid model. This 3D-printing model, along with the Three-Column classification, was utilized to plan the operation. During each operation, the operative time and amount of blood loss were recorded as primary outcome measures. Patients were followed to evaluate surgical outcomes using Rasmussen scores and radiological evaluation, which served as secondary outcome measures. Additionally, satisfaction for patients was assessed using questionnaires developed by Yiting Lou. Two-column fractures accounted for the highest proportion at 45.5%. Isolated posterior column fractures constituted 9.1%. The average 3D printing time was 7.1 ± 0.9 h; a material cost of 1 USD per model. Complex fracture cases had significantly longer 3D printing times (p = 0.001) and provided more information to the surgical team than simple fractures. Patient satisfaction with 3D models was rated at 7.4 ± 0.7 out of 10 points. Malalignment and gap width were not correlated with surgical time (p = 0.3 and 0.2). The infection rate was 3%, and the rate of secondary loss of reduction at six months was 25%, with no correlation with Rasmussen scores (P > 0.05, Fisher's test). Our study revealed that 3D printing models effectively assist the surgeons in planning operations, especially in complex cases, and may enhances communication between surgeons and patients. Follow-up 6 months after surgery showed good knee function.