Use of 3D printing and pre-contouring plate in the surgical planning of acetabular fractures: A systematic review

Background: Acetabular fractures are caused by high energy injuries. The treatment aims to reconstruct the articular surface, restoring the anatomical structure. The surgical management of these fractures is difficult because it requires familiarity with the 3D anatomy of the pelvis. With the use of 3D printing technique for planning surgery, this limitation could be overcome. Hypothesis: Studies examining the use of 3D printing in preoperative planning of acetabular fractures tend to agree on its usefulness. Methods: A systematic review of two electronic medical databases was performed by three independent authors, using the following inclusion criteria: any type of acetabular fracture and preoperative use of 3D printing to plan the surgery. Results: Among 93 screened articles, following selection criteria, six randomised controlled human trials (hRCT) were eligible for the study; articles compare a group in which a pre-contouring plate was performed through 3D printing with a control group in which the plate was intraoperatively modelled. Conclusion: This review demonstrates the advantage of 3D printing in terms of surgical time, reduction of blood losses, quality of fracture reduction, and fixation, and reporting best clinical outcomes. Level of evidence: II.