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      A Review on 3D-Printed Templates for Precontouring Fixation Plates in Orthopedic Surgery

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          Abstract

          This paper is a systematic review of the literature on 3D-printed anatomical replicas used as templates for precontouring the fixation plates in orthopedic surgery. Embase, PubMed, Cochrane, Scopus and Springer databases were consulted for information on design study, fracture anatomical location, number of patients, surgical technique, virtual modeling approach and 3D printing process. The initial search provided a total of 496 records. After removing the duplicates, the title and abstract screening, and applying exclusion criteria and citations searching, 30 papers were declared eligible and included in the final synthesis. Seven studies were identified as focusing on retrospective non-randomized series of clinical cases, while two papers presented randomized case control studies. Two main approaches were highlighted in developing 3D-printed anatomical models for precontouring fixation plates: (a.) medical reconstruction, virtual planning and fracture reduction followed by 3D printing the model; (b.) medical reconstruction followed by 3D printing the model of the mirrored uninjured side. Revised studies reported advantages such as surgical time and blood loss reduction, while the reduction quality is similar with that of the conventional surgery. During the last couple of years there was an increase in the number of studies focused on precontouring orthopedic plates using 3D printing technology. Three-dimensionally-printed templates for plate precontouring were mostly used for acetabular fractures. Knowledge on medical virtual modeling and reconstruction is mandatory.

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          Most cited references62

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          Advantages and disadvantages of 3-dimensional printing in surgery: A systematic review.

          Three-dimensional (3D) printing is becoming increasingly important in medicine and especially in surgery. The aim of the present work was to identify the advantages and disadvantages of 3D printing applied in surgery.
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            Operative versus nonoperative care of displaced midshaft clavicular fractures: a meta-analysis of randomized clinical trials.

            Recent studies have suggested benefits following primary operative fixation of substantially displaced midshaft fractures of the clavicle. We reviewed randomized clinical trials of operative versus nonoperative treatment of these fractures, and pooled the functional outcome and complication rates to arrive at summary estimates of these outcomes. A systematic review of the literature was performed to identify studies of randomized clinical trials comparing operative versus nonoperative care for displaced midshaft clavicular fractures. Six studies (n = 412 patients, mean Detsky score = 15.3) were included. The nonunion rate was higher in the nonoperatively treated patients (twenty-nine of 200) than it was in patients treated operatively (three of 212) (p = 0.001). The rate of symptomatic malunion was higher in the nonoperative group (seventeen of 200) than it was in the operative group (0 of 212) (p < 0.001). Operative treatment provided a significantly lower rate of nonunion and symptomatic malunion and an earlier functional return compared with nonoperative treatment. However, there is little evidence at present to show that the long-term functional outcome of operative intervention is significantly superior to nonoperative care.
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              Measuring and Establishing the Accuracy and Reproducibility of 3D Printed Medical Models

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                Author and article information

                Journal
                J Clin Med
                J Clin Med
                jcm
                Journal of Clinical Medicine
                MDPI
                2077-0383
                09 September 2020
                September 2020
                : 9
                : 9
                : 2908
                Affiliations
                [1 ]Department of Orthopedics, University of Medicine and Pharmacy Carol Davila, 020021 Bucharest, Romania; rodicamarinescu@ 123456ymail.com
                [2 ]Department of Robotics and Production Systems, University Politehnica of Bucharest, 060042 Bucharest, Romania
                [3 ]Department of Orthopedics 2, Colentina Clinical Hospital, 020125 Bucharest, Romania; danlaptoiu@ 123456yahoo.com
                Author notes
                [* ]Correspondence: diana@ 123456mix.mmi.pub.ro
                Author information
                https://orcid.org/0000-0002-8859-6923
                Article
                jcm-09-02908
                10.3390/jcm9092908
                7565448
                32916844
                2cf2e629-d2cd-4a3a-b07b-7a951f22b752
                © 2020 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 15 July 2020
                : 07 September 2020
                Categories
                Review

                orthopedic surgery,fixation plate,precontouring,3d printing,fractures

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