title: A novel combination of computer-assisted reduction technique and three dimensional printed patient-specific external fixator for treatment of tibial fractures.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
  
  
  RESULTS
  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 2.54° (±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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Hong-Hui Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China. qiaofeng7502@163.com.|Xi'an Hong Hui Hospital, No.555, Youyidong Rd, Xi'an, Shaanxi, 710054, China. qiaofeng7502@163.com.
authors.forename: Feng
authors.initials: F
authors.lastname: Qiao
authors.affiliation: Department of Orthopaedics, Second Affiliated Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710004, China.|State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.
authors.forename: Dichen
authors.initials: D
authors.lastname: Li
authors.affiliation: State Key Laboratory for Manufacturing System Engineering, School of Mechanical Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.|Institute of Medical and Biological Engineering, School of Mechanical Engineering, University of Leeds, Leeds, LS2 9JT, UK.
authors.forename: Zhongmin
authors.initials: Z
authors.lastname: Jin
authors.affiliation: Hong-Hui Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.
authors.forename: Dingjun
authors.initials: D
authors.lastname: Hao
authors.affiliation: Hong-Hui Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.
authors.forename: Yonghua
authors.initials: Y
authors.lastname: Liao
authors.affiliation: Hong-Hui Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.
authors.forename: Sihai
authors.initials: S
authors.lastname: Gong
mesh_terms: D000328:Adult; D016267:External Fixators; D005240:Feasibility Studies; D005592:Fracture Fixation / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D066330:Printing, Three-Dimensional; D025321:Surgery, Computer-Assisted; D013978:Tibial Fractures / Q000601:surgery*
keywords: 3D printing; Computer-assisted; Customized external fixator; Tibial fracture