A novel combination of computer-assisted reduction technique and three dimensional printed patient-specific external fixator for treatment of tibial fractures

Good reduction and appropriate fixation are critical for long bone fractures, however, neither has been addressed satisfactorily. Robotic and navigation techniques can help improve the reduction accuracy. However, their clinical applications are limited by high cost and complexity in operation. The aim of this study was to discuss the feasibility of a customized external fixator in treating long bone fractures. We combined a computer-assisted reduction technique with 3D printing to develop a customized external fixator for treating three cases of tibial fractures. The reduction accuracy and fixation results were discussed in terms of operation time, X-ray examinations after operation, and limb function recovery. Good reduction results were obtained on all three tibial fractures with an average lateral displacement of 2.04 mm (+/- 1.53) and an angulation of 2.54A degrees (+/- 1.33). The surgery was not experience-dependent, and no intra-operative X-ray examinations were conducted. The average operative time was 8.67 minutes (+/- 0.58). A novel customized external fixator for the treatment of tibial fractures has the advantages of easy manipulation, accurate reduction, appropriate fixation, minimal invasion and experience-independence, and therefore has huge potential in clinical applications.