title: Evaluation of three-dimensional printing for internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach: a preliminary report.
abstract: OBJECTIVE
  The aim of this study is to evaluate the efficacy and feasibility of three-dimensional printing (3D printing) assisted internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach.
  
  
  METHODS
  A total of 38 patients with unstable pelvic fractures were analyzed retrospectively from August 2012 to February 2014. All cases were treated operatively with internal fixation assisted by three-dimensional printing from minimal invasive para-rectus abdominis approach. Both preoperative CT and three-dimensional reconstruction were performed. Pelvic model was created by 3D printing. Data including the best entry points, plate position and direction and length of screw were obtained from simulated operation based on 3D printing pelvic model. The diaplasis and internal fixation were performed by minimal invasive para-rectus abdominis approach according to the optimized dada in real surgical procedure. Matta and Majeed score were used to evaluate currative effects after operation.
  
  
  RESULTS
  According to the Matta standard, the outcome of the diaplasis achieved 97.37% with excellent and good. Majeed assessment showed 94.4% with excellent and good. The imageological examination showed consistency of internal fixation and simulated operation. The mean operation time was 110 minutes, mean intraoperative blood loss 320 ml, and mean incision length 6.5 cm. All patients have achieved clinical healing, with mean healing time of 8 weeks.
  
  
  CONCLUSIONS
  Three-dimensional printing assisted internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach is feasible and effective. This method has the advantages of trauma minimally, bleeding less, healing rapidly and satisfactory reduction, and worthwhile for spreading in clinical practice.
authors.affiliation: Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Science, Southern Medical University Guangzhou 510515, Guangdong, China ; Department of Orthopedics, Third Affiliated Hospital of Southern Medical University Academy of Othopedics Guangdong Province, Guangzhou 510630, Guangdong, China.
authors.forename: Canjun
authors.initials: C
authors.lastname: Zeng
authors.affiliation: Department of Ultrasound Imaging, Third Xiangya Hospital, Central South University Changsha, China.
authors.forename: Jidong
authors.initials: J
authors.lastname: Xiao
authors.affiliation: Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Science, Southern Medical University Guangzhou 510515, Guangdong, China.
authors.forename: Zhanglin
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of Anatomy, Guangdong Provincial Key Laboratory of Medical Biomechanics, School of Basic Medical Science, Southern Medical University Guangzhou 510515, Guangdong, China.
authors.forename: Wenhua
authors.initials: W
authors.lastname: Huang
keywords: 3D printing; internal fixation; minimally invasive; para-rectus abdominis approach; pelvic fracture