Patient-specific implants are accurate and cost-effective for blow-out fracture reconstruction: a retrospective case-control study

BACKGROUND: The volume of the bony orbit increases in facial trauma with a blow-out fracture and may lead to enophthalmos and double vision. The orbit's volume can be restored surgically. The authors aimed to determine the most accurate and cost-effective method for reconstructing blow-out fractures: virtual surgical planning (VSP) combined with patient-specific implants (PSI) or standard titanium stock implants. MATERIALS AND METHODS: The authors conducted a retrospective study of patients who sustained a blow-out fracture requiring surgical reconstruction. Patients were categorized into two groups: the PSI group (n = 13) and the standard titanium stock implant group (n = 36). The primary aim was to analyze the total cost in each group, with a secondary aim to ensure volumetric restoration was achieved. Postoperative volume, operation time, need for reoperation, surgical and inpatient costs, and cost-effectiveness were calculated. The data were analyzed with Shapiro-Wilk, Mann-Whitney U test, and Fisher's exact test, using a significance level of 0.05. RESULTS: The operation time was significantly shorter in the PSI group than in the stock implant group, with an average of 89.77 and 122.69 min, respectively (p = 0.008), resulting in lower total costs in the PSI group. The PSI group had better postoperative volumetric restoration than the stock implant group compared to the contralateral side (p = 0.01). Four out of 36 patients (11%) needed reoperation in the stock implant group. CONCLUSIONS: Preliminary results suggest that PSI requires a shorter operation time and is therefore cost-effective without compromising surgical outcomes.