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3D-Druck in der Frakturversorgung

Aktuelle Praxis und „Best-practice“-Konsens

3D printing in fracture treatment

Current practice and best practice consensus

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Der Unfallchirurg Aims and scope Submit manuscript

A Leitthema to this article was published on 11 July 2022

Zusammenfassung

Der Einsatz des 3D-Drucks zur Versorgung von Frakturen wird durch klinische Evidenz gestützt. Vorhandene CT-Daten werden für eine verbesserte stereotaktile Identifizierung der morphologischen Frakturmerkmale und eine verbesserte Operationsplanung genutzt. Aufgrund komplexer logistischer, technischer Schwierigkeiten und Ressourcenbeschränkungen ist die Nutzung des 3D-Drucks aus Sicht des Krankenhausmanagements nicht einfach. Infolgedessen können nicht alle Unfallchirurgen den 3D-Druck in ihre tägliche Praxis integrieren. In 6 unfallchirurgischen Kliniken, die diesen in der Routine nutzen, wurde eine Expertenbefragung durchgeführt. Die häufigsten Indikationen sind Acetabulum- oder andere Gelenkfrakturen und Fehlstellungen. Infra- und Personalstruktur variierten zwischen den Einheiten. Die Installation von Industriemaschinen und dedizierter Software sowie der Einsatz von geschultem Personal können die Kapazität und Zuverlässigkeit der Frakturversorgung erhöhen. Die Errichtung von interdisziplinär gemeinsam genutzten 3D-Druck-Abteilungen mit einer soliden Finanz- und Managementstruktur kann die Nachhaltigkeit verbessern. Die z. T. erheblichen logistischen und technischen Barrieren, die die schnelle Lieferung von 3D-gedruckten Modellen behindern, werden diskutiert.

Abstract

The use of 3D printing in orthopedic trauma is supported by clinical evidence. Existing computed tomography (CT) data are exploited for better stereotactic identification of morphological features of the fracture and enhanced surgical planning. Due to complex logistic, technical and resource constraints, deployment of 3D printing is not straightforward from the hospital management perspective. As a result not all trauma surgeons are able to confidently integrate 3D printing into the daily practice. We carried out an expert panel survey on six trauma units which utilized 3D printing routinely. The most frequent indications are acetabular and articular fractures and malalignments. Infrastructure and manpower structure varied between units. The installation of industrial grade machines and dedicated software as well as the use of trained personnel can enhance the capacity and reliability of fracture treatment. Setting up interdisciplinary jointly used 3d printing departments with sound financial and management structures may improve sustainability. The sometimes substantial logistic and technical barriers which impede the rapid delivery of 3D printed models are discussed.

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Authors and Affiliations

  1. Queen Mary Hospital, Hong Kong SAR, Volksrepublik China

    Christian Fang MD

  2. First Affiliated Hospital, Wenzhou Medical University, Wenzhou, Volksrepublik China

    Leyi Cai

  3. United Christian Hospital, Hong Kong SAR, Volksrepublik China

    Gabriel Chu

  4. Bhumibol Adulyadej Hospital, Bangkok, Thailand

    Rahat Jarayabhand

  5. Asan Medical Centre, University of Ulsan College of Medicine, Ulsan, Südkorea

    Ji Wan Kim

  6. National University Hospital, Singapur, Singapur

    Gavin O’Neill

Authors
  1. Christian Fang MD
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  2. Leyi Cai
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  3. Gabriel Chu
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  4. Rahat Jarayabhand
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  5. Ji Wan Kim
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  6. Gavin O’Neill
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Corresponding author

Correspondence to Christian Fang MD.

Ethics declarations

Interessenkonflikt

C. Fang, L. Cai, G. Chu, R. Jarayabhand, J.W. Kim und G.O’Neill geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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Christian Krettek, Hannover

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Fang, C., Cai, L., Chu, G. et al. 3D-Druck in der Frakturversorgung. Unfallchirurg 125, 342–350 (2022). https://doi.org/10.1007/s00113-022-01158-z

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  • DOI: https://doi.org/10.1007/s00113-022-01158-z

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