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Application of computer-aided design and 3D-printed navigation template in Locking Compression Pediatric Hip Plate\(^{\mathrm{TM}}\) placement for pediatric hip disease

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Background

To investigate the feasibility and accuracy of a drill template based on computer-aided design (CAD) and 3D printing technology for the placement of screws in Locking Compression Pediatric Hip Plate (LCP-PHP).

Methods

LCP-PHP was used in 11 children [5 with femoral neck fracture and 6 with development dysplasia of hip (DDH)]. Using the CT data, the proximal femur model was created by a 3D printer. Fracture reduction and the placement of the screw in the femoral neck and the LCP-PHP were simulated by the computer. The navigation template was designed by the software to match the proximal femur. After the feasibility of the 3D model operation was demonstrated before the operation, the guide pins and the screws were inserted with the help of the navigate template in the operation.

Results

During surgery, the navigation template for each case was matched to the bony markers of the proximal femur. With the help of the template, in femoral neck fracture cases, three screws could be accurately inserted into the femoral neck to implant the LCP-PHP and stabilize the fracture. The template for DDH includes all operation parameters and steps for proximal femoral varus rotation and shortening osteotomy, which made the surgery much easier to perform. Radiographs taken after surgery showed that the postoperative results closely corresponded to the preoperative computer simulation. The average time taken for LCP-PHP placement was 26.5 min; radiography was used during surgery only for an average of 6.0 times. Postoperative radiographs showed good results.

Conclusion

With the use of CAD and 3D printing technology, accurate placement of individualized navigation template of LCP-PHP can be achieved. This technology can reduce intraoperative damage to the femoral neck epiphysis, decrease operation time, reduce intraoperative hemorrhage, and decrease radiation exposure to patients and personnel during the surgery.

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References

  1. Joeris A, Audigé L, Ziebarth K, SlongoT (2012) The Locking Compression Paediatric Hip Plate: technical guide and critical analysis. Int Orthop 36(11):2299–2306. doi:10.1007/s00264-012-1643-1

    Article  PubMed  PubMed Central  Google Scholar 

  2. Ročák K, Poul J, Urbášek K (2013) Accuracy of proximal femur correction achieved with LCP Paediatric Hip Plates. Acta Chir Orthop Traumatol Cech 80(4):273–277

    PubMed  Google Scholar 

  3. Sidler-Maier CC, Reidy K, Huber H, Dierauer S, Ramseier LE (2014) LCP \(140^{\circ }\) Pediatric Hip Plate for fixation of proximal femoral valgisation osteotomy. J Child Orthop 8(1):29–35. doi:10.1007/s11832-014-0550-y

    Article  PubMed  PubMed Central  Google Scholar 

  4. Zhou Leena, Camp Mark, Gahukamble Abhay, Khot A, Graham HK (2015) Cannulated, locking blade plates for proximal femoral osteotomy in children and adolescents. J Child Orthop 9:121–127. doi:10.1007/s11832-015-0649-9

    Article  PubMed  PubMed Central  Google Scholar 

  5. Spence D, DiMauro JP, Miller PE, Glotzbecker MP, Hedequist DJ, Shore BJ (2016) Osteonecrosis after femoral neck fractures in children and adolescents: analysis of risk factors. J Pediatr Orthop 36(2):111–116. doi:10.1097/BPO.0000000000000424

    Article  PubMed  Google Scholar 

  6. Maeda S, Kita A, Fujii G, Funayama K, Yamada N, Kokubun S (2003) Avascular necrosis associated with fractures of the femoral neck in children: histological evaluation of core biopsies of the femoral head. Injury 34(4):283–286

    Article  CAS  PubMed  Google Scholar 

  7. Chen H, Wang G, Li R, Sun Y, Wang F, Zhao H, Zhang P, Zhang X (2016) A novel navigation template for fixation of acetabular posterior column fractures with antegrade lag screws: design and application. Int Orthop 40(4):827–34. doi:10.1007/s00264-015-2813-8

    Article  PubMed  Google Scholar 

  8. Kaneyama S, Sugawara T, Sumi M (2015) Safe and accurate midcervical pedicle screw insertion procedure with the patient-specific screw guide template system. Spine (Phila Pa 1976) 40(6):341–348. doi:10.1007/s00264-015-2813-8

    Article  Google Scholar 

  9. Ye N, Long H, Zhu S, Yang Y, Lai W, Hu J (2015) The accuracy of computer image-guided template for mandibular angle ostectomy. Aesthet Plast Surg 39(1):117–123. doi:10.1007/s00266-014-0424-1

    Article  Google Scholar 

  10. Huang X, Li F, Zhang F, Wang K, Wang K, Yang Q, Dang R, Su J, Shen H, Li M (2014) A cadaveric study on establishing an individualized navigation template for the placement of occipital condyle screws using a three-dimensional printing technique. Zhonghua Wai Ke Za Zhi 52(7):523–528

    PubMed  Google Scholar 

  11. Li L, Zhao GQ, Zhu J (2013) Treatment of trochanteric fracture in children with LCP-PHP. Chin J Pediatr Surg 34(6):474–476

    Google Scholar 

  12. Kunz M, Rudan JF, Xenoyannis GL, Ellis RE (2010) Computer-assisted hip resurfacing using individualized drill templates. J Arthroplasty 25(4):600–606. doi:10.1016/j.arth.2009.03.023

    Article  PubMed  Google Scholar 

  13. Kunz M, Balaketheeswaran S, Ellis RE, Rudan JF (2015) The influence of osteophyte depiction in CT for patient-specific guided hip resurfacing procedures. Int J Comput Assist Radiol Surg 10(6):717–726. doi:10.1007/s11548-015-1200-7

    Article  CAS  PubMed  Google Scholar 

  14. Hananouchi T, Saito M, Koyama T, Sugano N, Yoshikawa H (2010) Tailor-made surgical guide reduces incidence of outliers of cup placement. Clin Orthop Relat Res 468(4):1088–1095. doi:10.1007/s11999-009-0994-4

    Article  PubMed  Google Scholar 

  15. Zhang YZ, Chen B, Lu S, Yang Y, Zhao JM, Liu R, Li YB, Pei GX (2011) Preliminary application of computer-assisted patient-specific acetabular navigational template for total hip arthroplasty in adult single development dysplasia of the hip. Int J Med Robot 7(4):469–474. doi:10.1002/rcs.423

    Article  PubMed  Google Scholar 

  16. Audenaert E, De Smedt K, Gelaude F, Clijmans T, Pattyn C, Geebelen B (2011) A custom-made guide for femoral component positioning in hip resurfacing arthroplasty: development and validation study. Comput Aided Surg 16(6):304–309. doi:10.3109/10929088.2011.613951

    Article  CAS  PubMed  Google Scholar 

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Funding

This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.

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    Authors and Affiliations

    1. Department of Pediatric Orthopaedics, Children’s Hospital, Nanjing Medical University, Nanjing, 210008, Jiangsu, China

      Pengfei Zheng & Peng Xu

    2. Digital Medicine Institute, Nanjing Medical University, Nanjing, 210006, Jiangsu, China

      Pengfei Zheng, Qingqiang Yao, Peng Xu & Liming Wang

    3. Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, Jiangsu, China

      Qingqiang Yao & Liming Wang

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    1. Pengfei Zheng
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    2. Qingqiang Yao
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    3. Peng Xu
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    4. Liming Wang
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    Correspondence to Liming Wang.

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    The authors declare that they have no conflict of interest.

    Ethical approval

    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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    Informed consent was obtained from all individual participants included in the study.

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    Pengfei Zheng and Qingqiang Yao contributed equally to this work.

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    Zheng, P., Yao, Q., Xu, P. et al. Application of computer-aided design and 3D-printed navigation template in Locking Compression Pediatric Hip Plate\(^{\mathrm{TM}}\) placement for pediatric hip disease. Int J CARS 12, 865–871 (2017). https://doi.org/10.1007/s11548-017-1535-3

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    • DOI: https://doi.org/10.1007/s11548-017-1535-3

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