Skip to main content

Advertisement

SpringerLink
Log in

A new universal 3D-printable device to prevent excessive drilling in orthopedic surgery

  • Original Article
  • Published:
European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Introduction

The occurrence of vascular injury during drilling is a rare but severe complication. Unfortunately, drilling protection systems are not available in all hospitals. Thanks to the development of 3D printing in recent years, sharing devices and materials to solve surgical problems has become easy and inexpensive. The objective of our work is to evaluate a universal, freely accessible, 3D-printable drilling protection device.

Materials and methods

A prospective, randomized, and triple-blind evaluation of excess drilling was evaluated in expert surgeons and resident surgeons without the use of the protection device. Subsequently, excess drilling was assessed using the device in both groups. The differences in drilling lengths between both groups with and without the device were analyzed to establish the reduction of excess drilling in both groups.

Results

The drilling in the expert surgeon without device group was 3.03 mm (SD 1.69 95% CI 2.40–3.66 p value = 9.89e−11), while the resident surgeon with device group performed excess drilling of 1.76 mm (SD 0.89 CI 95% 1.43–2.10). Results showed better results in the resident surgeon with device group than in the expert surgeons with device group (p value ˂ 0.01). The device improved drilling in both resident surgeons (5.77 mm) and expert surgeons (1.17 mm).

Conclusions

The device improves drilling in both expert surgeons and resident surgeons, showing greater benefits in the latter. The device is printable with any 3D printer, making it universally accessible, inexpensive, and effective, allowing expert surgeons to improve precision in high-risk situations and resident surgeons to improve their technique without increasing risk to the patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5

Similar content being viewed by others

References

  1. Sözen T, Özışık L, Başaran NÇ. An overview and management of osteoporosis. Eur J Rheumatol. 2017;4(1):46–56.

    Article  Google Scholar 

  2. Kani KK, Porrino JA, Mulcahy H, Chew FS. Fragility fractures of the proximal femur: review and update for radiologists. Skeletal Radiol. 2019;48(1):29–45.

    Article  Google Scholar 

  3. Bhandari M, Swiontkowski M. Management of acute hip fracture. N Engl J Med. 2017;377(21):2053–62.

    Article  Google Scholar 

  4. Court-Brown CM, Duckworth AD, Clement ND, McQueen MM. Fractures in older adults. A view of the future? Injury. 2018;49(12):2161–6.

    Article  Google Scholar 

  5. Rosengren BE, Karlsson MK. The annual number of hip fractures in Sweden will double from year 2002 to 2050: projections based on local and nationwide data. Acta Orthop. 2014;85(3):234–7.

    Article  Google Scholar 

  6. LeBlanc KE, Muncie HLJ, LeBlanc LL. Hip fracture: diagnosis, treatment, and secondary prevention. Am Fam Physician. 2014;89(12):945–51.

    PubMed  Google Scholar 

  7. Potera C. Seniors need hip fracture surgery within 24 hours. Am J Nurs. 2018;118(3):14.

    Article  Google Scholar 

  8. Haviari S. Wait time for hip fracture surgery and mortality. JAMA. 2018;319(21):2234.

    Article  Google Scholar 

  9. Roberts KC, Brox WT, Jevsevar DS, Sevarino K. Management of hip fractures in the elderly. J Am Acad Orthop Surg. 2015;23(2):131–7.

    Article  Google Scholar 

  10. Chlebeck JD, Birch CE, Blankstein M, Kristiansen T, Bartlett CS, Schottel PC. Nonoperative geriatric hip fracture treatment is associated with increased mortality: a matched cohort Study. J Orthop Trauma. 2019;33(7):346–50.

    Article  Google Scholar 

  11. Carulli C, Piacentini F, Paoli T, Civinini R, Innocenti M. A comparison of two fixation methods for femoral trochanteric fractures: a new generation intramedullary system vs sliding hip screw. Clin Cases Miner Bone Metab Off J Ital Soc Osteoporos Miner Metab Skelet Dis. 2017;14(1):40–7.

    Google Scholar 

  12. Stockton DJ, Dua K, O’Brien PJ, Pollak AN, Hoshino CM, Slobogean GP. Failure patterns of femoral neck fracture fixation in young patients. Orthopedics. 2019;42(4):e376–e380380.

    Article  Google Scholar 

  13. Chughtai M, Khlopas A, Mont MA. Fracture fixation in the operative management of hip fractures (FAITH): an international, multicentre, randomised controlled trial. Lancet Lond Engl. 2017;389(10078):1519–27.

    Article  Google Scholar 

  14. Zhang B-F, Cong Y-X, Wang P-F, Huang H, Wang H, Zhuang Y. Deep femoral artery branch pseudoaneurysm formation and injury after hip fracture surgery: a case series and a literature review. Medicine (Baltimore). 2018;97(6):e9872.

    Article  Google Scholar 

  15. Barquet A, Gelink A, Giannoudis PV. Proximal femoral fractures and vascular injuries in adults: incidence, aetiology and outcomes. Injury. 2015;46(12):2297–313.

    Article  Google Scholar 

  16. Neubauer T, Grechenig S, Leitner L, Auffarth A, Plecko M. Vascular complications in plating of the proximal femur: review. Arch Orthop Trauma Surg. 2016;136(4):539–51.

    Article  Google Scholar 

  17. Tomčovčík L, Kováč P, Daňo J, Čuha R. Late laceration of the superficial femoral artery by an intertrochanteric fracture fragment. Hip Int J Clin Exp Res Hip Pathol Ther. 2011;21(2):273–5.

    Google Scholar 

  18. Clement H, Heidari N, Grechenig W, Weinberg AM, Pichler W. Drilling, not a benign procedure: laboratory simulation of true drilling depth. Injury. 2012;43(6):950–2.

    Article  Google Scholar 

  19. McIntosh AL. Surgical treatment of adolescent clavicle fractures: results and complications. J Pediatr Orthop. 2016;36(Suppl 1):S41–43.

    Article  Google Scholar 

  20. Bernhoff K, Björck M. Iatrogenic popliteal artery injury in non arthroplasty knee surgery. Bone Jt J. 2015;97-B(2):192–6.

    Article  CAS  Google Scholar 

  21. Wang X-Z, Shi Z, Lu Q-L, Xie W, Chen L, Li X-G, et al. Treatment of old acetabular posterior wall fracture with 3D printing combined with composite plate internal fixation. Zhongguo Gu Shang China J Orthop Traumatol. 2019;32(5):395–400.

    Google Scholar 

  22. You W, Liu LJ, Chen HX, Xiong JY, Wang DM, Huang JH, et al. Application of 3D printing technology on the treatment of complex proximal humeral fractures (Neer3-part and 4-part) in old people. Orthop Traumatol Surg Res OTSR. 2016;102(7):897–903.

    Article  CAS  Google Scholar 

  23. Tomaževič M, Kristan A, Kamath AF, Cimerman M. 3D printing of implants for patient-specific acetabular fracture fixation: an experimental study. Eur J Trauma Emerg Surg Off Publ Eur Trauma Soc. 2019

Download references

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

Author information

Authors and Affiliations

  1. La Fe Hospital, Av Fernando Abril Martorell 106, 46026, Valencia, Spain

    Joan Ferràs-Tarragó, Pablo Jordà-Gómez, Juan Català-de-las-Marinas, Juan Manuel Antequera-Cano & Mariano Barrés-Carsí

Authors
  1. Joan Ferràs-Tarragó
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pablo Jordà-Gómez
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Juan Català-de-las-Marinas
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Juan Manuel Antequera-Cano
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mariano Barrés-Carsí
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joan Ferràs-Tarragó.

Ethics declarations

Conflict of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Patient consent and ethical approval

The patient provided written informed consent for the publication of medical information and images.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ferràs-Tarragó, J., Jordà-Gómez, P., Català-de-las-Marinas, J. et al. A new universal 3D-printable device to prevent excessive drilling in orthopedic surgery. Eur J Trauma Emerg Surg 48, 3887–3893 (2022). https://doi.org/10.1007/s00068-020-01465-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00068-020-01465-3

Keywords

Search

Navigation