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Scheuermann et al: Minimally invasive plate osteosynthesis of femoral fractures with 3D‐printed bone models and custom surgical guides: A cadaveric study in dogs
Veterinary Surgery 6, 2023

🔍 Key Findings

  • Precontoured plates using 3D-printed femoral models achieved near-anatomic alignment in all cadaver limbs.
  • Fracture reduction system (FRS) required significantly fewer fluoroscopy images than intramedullary pin (IMP) methods (7 vs 26, P = .001).
  • Despite longer surgical time (43 vs 29 minutes, P = .011), FRS showed equally accurate or better alignment compared to IMP.
  • Femoral length, frontal, sagittal, and axial alignment were all within near-anatomic thresholds (<10 mm or <5° deviation) in both groups.
  • FRS was associated with more consistent length maintenance, with IMP showing a median shortening of 2.3 mm (P = .03).
  • Axial plane deviation was statistically different in the FRS group (P = .04), but still clinically acceptable.
  • Study highlights potential for custom 3D-printed guides to reduce radiation exposure and improve precision in MIPO procedures.
  • Authors caution that FRS was time-consuming and cumbersome, suggesting design refinements needed for clinical use.

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← Articles

Scheuermann et al: Minimally invasive plate osteosynthesis of femoral fractures with 3D‐printed bone models and custom surgical guides: A cadaveric study in dogs
Veterinary Surgery 6, 2023

🔍 Key Findings

  • Precontoured plates using 3D-printed femoral models achieved near-anatomic alignment in all cadaver limbs.
  • Fracture reduction system (FRS) required significantly fewer fluoroscopy images than intramedullary pin (IMP) methods (7 vs 26, P = .001).
  • Despite longer surgical time (43 vs 29 minutes, P = .011), FRS showed equally accurate or better alignment compared to IMP.
  • Femoral length, frontal, sagittal, and axial alignment were all within near-anatomic thresholds (<10 mm or <5° deviation) in both groups.
  • FRS was associated with more consistent length maintenance, with IMP showing a median shortening of 2.3 mm (P = .03).
  • Axial plane deviation was statistically different in the FRS group (P = .04), but still clinically acceptable.
  • Study highlights potential for custom 3D-printed guides to reduce radiation exposure and improve precision in MIPO procedures.
  • Authors caution that FRS was time-consuming and cumbersome, suggesting design refinements needed for clinical use.

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Multiple Choice Questions on this study

In Scheuermann 2023 et al., on femoral MIPO alignment, which of the following was significantly different in the FRS group compared to the virtual plan?

A. Frontal plane alignment
B. Sagittal plane alignment
C. Femoral length
D. Femoral rotation
E. All alignment metrics were unchanged

Answer: Sagittal plane alignment

Explanation: FRS resulted in increased recurvatum (median 2.9°; P = .03), but all remained within acceptable range.
In Scheuermann 2023 et al., on canine femoral MIPO, what clinical advantage might 3D-printed custom surgical guides offer during MIPO procedures?

A. Reduced need for anesthesia
B. Major reduction in implant cost
C. Improved intra-articular screw positioning
D. Reduced radiation exposure to the surgical team
E. Elimination of need for implants

Answer: Reduced radiation exposure to the surgical team

Explanation: Fewer intraoperative fluoroscopy images were needed with custom guides, reducing radiation risk.
In Scheuermann 2023 et al., on femoral MIPO alignment, what was a noted limitation of the prototype FRS?

A. It could not be used without fluoroscopy
B. It significantly reduced surgical time
C. It was not customizable to each patient
D. It was too fragile for repeated use
E. It was cumbersome and inefficient

Answer: It was cumbersome and inefficient

Explanation: Authors noted the system was bulky, time-consuming, and difficult to use clinically in its current form.
In Scheuermann 2023 et al., on femoral MIPO alignment, which statement about fluoroscopy use is most accurate?

A. Fluoroscopy was not required in either group
B. FRS required more fluoroscopy than IMP
C. IMP required more fluoroscopy than FRS
D. Fluoroscopy time was equal in both groups
E. Fluoroscopy was only used in the FRS group

Answer: IMP required more fluoroscopy than FRS

Explanation: Fewer fluoroscopic images were required in the FRS group compared to the IMP group (median 7 vs 26).
In Scheuermann 2023 et al., on femoral MIPO alignment, which reduction system resulted in longer surgical times?

A. Intramedullary pinning (IMP)
B. Fracture Reduction System (FRS)
C. Neither; both were equal
D. Depends on surgeon experience
E. Only the IMP group was timed

Answer: Fracture Reduction System (FRS)

Explanation: FRS procedures were significantly longer than IMP (median 43 vs 29 min; P = .011).
In Scheuermann 2023 et al., on canine femoral MIPO, what was the most significant drawback observed with the use of the FRS?

A. Unacceptable femoral length reduction
B. Intra-articular implant placement
C. Increased radiation exposure
D. Longer surgical time
E. High rate of hardware loosening

Answer: Longer surgical time

Explanation: FRS procedures had a significantly longer surgical time than IMP (43 vs 29 minutes; P = .011).

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