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PREOPERATIVE PLANNING WITH 3D-PRINTED MODELS IN INTERNAL FIXATION FOR COMPLEX TIBIAL PLATEAU FRACTURES: A CASE SERIES
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Abstract
Objectives: To evaluate the feasibility and early outcomes of preoperative planning using 3D-printed models with fragment segmentation and full simulation of internal fixation in Schatzker V/VI tibial plateau fractures. Subjects and methods: A descriptive case series of 10 patients with S. V/VI tibial plateau fractures treated with open reduction and internal fixation (ORIF) using 3D-printed models for preoperative planning, from January 2025 to April 2026, at the Hospital for Traumatology and Orthopaedics. Patient-specific fracture models were generated from DICOM data using 3D Slicer and Blender, then printed at 1:1 scale on a Creality Ender 5 Pro FDM printer with PLA filament, with 1-mm bridges preserving the initial displacement. Full surgical simulation (reduction – temporary fixation – plate and screw placement) was performed on the printed model. Outcomes assessed: anatomical reduction (Rasmussen's radiological score), knee function (HSS, Rasmussen clinical score), operative time, blood loss, number of fluoroscopic exposures, and adherence to the surgical plan. Results: Mean age was 48.6 ± 13.2 years; 80% were female. Model preparation was completed within one day. Mean operative time was 117 ± 18 min; mean blood loss 260 ± 69.9 mL; mean fluoroscopic exposures 15.1 ± 4.6; full adherence to the plan was achieved in 80% of cases. The postoperative Rasmussen’s radiographic score was 16.4 ± 1.3 (70% excellent, 30% good). At final follow-up, the HSS score was 81.9 ± 5.5 and the Rasmussen clinical score was 24.9 ± 2.9 (90% good – excellent). Mean time to union was 13.4 ± 2.1 weeks. Mean follow-up was 13.6 ± 1.2 months. One case of knee osteoarthritis was recorded. Conclusion: Preoperative planning using 3D-printed models with fragment segmentation and full simulation of internal fixation is feasible and safe, providing good anatomical and functional outcomes in complex S. V/VI tibial plateau fractures.
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Keywords
Tibial plateau fracture, S. V/VI, 3D printing, preoperative planning, internal fixation.
References
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