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Purpose <p>Persistent malalignment—especially rotational error—after fixation of comminuted femoral shaft fractures compromises function and often necessitates revision surgery. This study evaluated whether point-of-care, patient-specific three-dimensional printed reduction guides can reproducibly restore native femoral length, coronal–sagittal alignment and axial rotation in a cadaveric model simulating highly comminuted shaft fractures.</p> Methods <p>Ten freshfrozen human legs were CTscanned, virtually reduced, and fitted with patientspecific guides printed in a sterilizable medical resin. A 2&#xa0;cm midshaft segment was resected to simulate a comminuted fracture. Each construct was reduced with the guides and stabilized with a locking compression plate. Postoperative CT volumes were superimposed to the preoperative plan to quantify absolute deviations in length, coronal (varus/valgus), sagittal (procurvatum/recurvatum), and axial rotation.</p> Results <p>All reductions were completed without technical difficulty. Mean ± SD absolute errors were 1.50 ± 1.08&#xa0;mm in length, 0.92 ± 0.41° in the coronal plane, 1.33 ± 1.34° in the sagittal plane, and 4.33 ± 1.88° in rotation—well within acceptable clinical limits.</p> Conclusion <p>On‑site printed, patient‑specific guides achieved high accuracy in a comminuted femoral fracture model. Clinical studies are required to determine whether this accuracy translates into improved patient outcomes.</p>

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High-Accuracy reduction of comminuted diaphyseal femur fractures using on-site 3-D-printed guides

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月23日

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  • Sophie C. Eberlein,
  • Samuel F. Schaible,
  • Frank M. Klenke,
  • Andreas Hecker

摘要

Purpose

Persistent malalignment—especially rotational error—after fixation of comminuted femoral shaft fractures compromises function and often necessitates revision surgery. This study evaluated whether point-of-care, patient-specific three-dimensional printed reduction guides can reproducibly restore native femoral length, coronal–sagittal alignment and axial rotation in a cadaveric model simulating highly comminuted shaft fractures.

Methods

Ten freshfrozen human legs were CTscanned, virtually reduced, and fitted with patientspecific guides printed in a sterilizable medical resin. A 2 cm midshaft segment was resected to simulate a comminuted fracture. Each construct was reduced with the guides and stabilized with a locking compression plate. Postoperative CT volumes were superimposed to the preoperative plan to quantify absolute deviations in length, coronal (varus/valgus), sagittal (procurvatum/recurvatum), and axial rotation.

Results

All reductions were completed without technical difficulty. Mean ± SD absolute errors were 1.50 ± 1.08 mm in length, 0.92 ± 0.41° in the coronal plane, 1.33 ± 1.34° in the sagittal plane, and 4.33 ± 1.88° in rotation—well within acceptable clinical limits.

Conclusion

On‑site printed, patient‑specific guides achieved high accuracy in a comminuted femoral fracture model. Clinical studies are required to determine whether this accuracy translates into improved patient outcomes.