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. 2021:7:36.
doi: 10.1051/sicotj/2021028. Epub 2021 May 20.

Quantitative fit analysis of acromion fracture plating systems using three-dimensional reconstructed scapula fractures - A multi-observer study

Johan Charilaou  1 , Roopam Dey  2 , Marilize Burger  3 , Sudesh Sivarasu  4 , Ruan van Staden  1 , Stephen Roche  1
Affiliations

Quantitative fit analysis of acromion fracture plating systems using three-dimensional reconstructed scapula fractures - A multi-observer study

Johan Charilaou et al. SICOT J. 2021.

Abstract

Introduction: Surgical treatment of displaced acromial and scapula spine fractures may be challenging due to the bony anatomy and variable fracture patterns. This difficulty is accentuated by the limitations of the available scapular plates for fracture fixation. This study compares the quantitative fitting of anatomic scapular plates and clavicle plates, using three-dimensional (3D) printed fractured scapulae.

Methods: Fourteen scapulae with acromion and spine fractures were used for this study. Computerized tomographic (CT) scans of the fractured scapulae were obtained from the Philips picture archiving and communication system (PACS) database of patients admitted to a tertiary teaching hospital in Cape Town, South Africa between 2012 and 2016. The reconstructed scapulae were 3D printed and the anatomical acromion and clavicle plates were templated about the fracture regions. The fit assessment was performed by five observers who classified the plates as no-fit, intermediate fit, and anatomical fit according to the surgical guidelines.

Results: The 6-hole anterior clavicle plate performed better than any of the scapular plates as they were able to fit 45.7% of the fractured acromion, including the spine. Among the pre-contoured anatomical scapula plates, both the short and the long acromion plates could fit only 27.3% of the fractured acromion. The intraclass correlation coefficient was 0.965 suggesting excellent consensus among the five observers.

Conclusion: Clavicle plates were found to be better suited to fit around a scapula fracture in its acromion and spine region.

Keywords: Acromion fracture; Additive manufacturing; Clavicle plates; Quantitative fit; Scapula plates.

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Figures

Figure 1
Figure 1
The bone reconstruction platform of Materialise Mimics® that was used for all the fractured scapula in this study.
Figure 2
Figure 2
This image shows the type of fracture patterns that were encountered in this study. The fracture lines are highlighted using marker. (A) Type I fracture; (B) type II fracture; (C) type III fracture.
Figure 3
Figure 3
The complete set of plates used in this quantitative fit analysis of acromion fracture.
Figure 4
Figure 4
Description of the different classifications employed to analyse the quantitative fit of the scapula plates around a fracture.
Figure 5
Figure 5
The overall quantitative fit of each plate when templated against acromion and spine fractures.
Figure 6
Figure 6
Frequency of the observed anatomical fits for each plate segregated for different types of fractures.
See this image and copyright information in PMC

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