Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2020 Nov;48(11):300060520972088.
doi: 10.1177/0300060520972088.

Clinical application of multiple 3D-printed guide plates for precise reduction and fixation of comminuted patellar fractures

Zhi-Sheng Long  1 , Fei-Peng Gong  1 , Xie-Ping Dong  1 , Jing-Tang Li  1
Affiliations
Case Reports

Clinical application of multiple 3D-printed guide plates for precise reduction and fixation of comminuted patellar fractures

Zhi-Sheng Long et al. J Int Med Res. 2020 Nov.

Abstract

Because of the lack of anatomical landmarks during reduction of multiple articular surfaces and fragments in comminuted patellar fractures, loss of bone fragments or aggravation of soft tissue and ligament injuries readily occurs. In the present case, we used multiple three-dimensional (3D)-printed guide plates to reduce and fix a comminuted patellar fracture. A 22-year-old man was hospitalized for 2 days because of left knee joint pain and limited movement caused by a traffic accident. Preoperative imaging revealed a comminuted fracture of the left patella (type 34-C3 according to the AO/OTA classification). Throughout a 2-year follow-up, the patient remained in generally good condition with no significant limitation of his left knee joint activity. Application of multiple 3D-printed guide plates is a safe and effective auxiliary technique for the treatment of comminuted patellar fractures. This novel technique can shorten the operation time, reduce the number of fluoroscopic procedures, and ensure fracture healing and recovery of knee joint function through reliable reduction of the articular surface.

Keywords: Three-dimensional printing; articular surface; auxiliary technique; comminuted patellar fracture; guide plate; precise reduction.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interest: The authors declare that there is no conflict of interest.

Ethics and consent statements: This study was conducted in accordance with the declaration of Helsinki and with approval from the Ethics Committee of Jiangxi Provincial People’s Hospital Affiliated to Nanchang University. Written informed consent was obtained from the patient.

Figures

Figure 1.
Figure 1.
Preoperative imaging examination of the left patella. (a) Lateral radiograph of left patella fracture. (b) Anteroposterior radiograph left patella fracture. (c, d) Computed tomography image of left patella fracture.
Figure 2.
Figure 2.
Morphology of patella presented in Mimics 19.0 software and morphology of reduction after attachment of guide plates. (a, b) Morphology of left patella fracture in Mimics 19.0 software. (c–e) Simulation and design of guide plate of left patella fracture in Mimics 19.0 software.
Figure 3.
Figure 3.
(a) Multiple guide plates and patella model printed by 3D printer. (b) Resetting and fixation of the bone blocks under the guidance of the guide plate. (c) Good restoration of the articular surface.
Figure 4.
Figure 4.
General appearance and postoperative imaging examination of left patella. (a) Anteroposterior radiograph after fixation of left patella fracture. (b) Lateral radiograph after fixation of left patella fracture. (c) Two years postoperatively, the left knee joint activity was normal.
See this image and copyright information in PMC

References

    1. Milankov M, Rasović P, Kovacev N, et al. Fracture of the patella after the anterior cruciate ligament reconstruction. Med Pregl 2012; 65: 476–482. - PubMed
    1. Schuett DJ, Hake ME, Mauffrey C, et al. Current treatment strategies for patella fractures. Orthopedics 2015; 38: 377–384. DOI: 10.3928/01477447-20150603-05. - PubMed
    1. Zhang YW, Xiao X, Gao WC, et al. Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity. J Orthop Surg Res 2019; 14: 353. DOI: 10.1186/s13018-019-1403-7. - PMC - PubMed
    1. Zhang YW, Xiao X, Xiao Y, et al. Efficacy and prognosis of 3D printing technology in treatment of high-energy trans-syndesmotic ankle fracture dislocation – “log-splitter” injury. Med Sci Monit 2019; 25: 4233–4243. DOI: 10.12659/msm.916884. - PMC - PubMed
    1. Lorich DG, Warner SJ, Schottel PC, et al. Multiplanar fixation for patella fractures using a low-profile mesh plate. J Orthop Trauma 2015; 29: e504–e510. DOI: 10.1097/bot.0000000000000415. - PubMed

Publication types