3D Planned Surgery of Acute Fractures Performed With 3D Guides Printed at the Point of Care

NCT ID: NCT05741892

Last Updated: 2023-12-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

15 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-04-01

Study Completion Date

2025-12-01

Brief Summary

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The aim of the study is to assess the accuracy of fracture reduction performed with surgical guides designed and 3D printed at the point of care in comminuted fractures of femur- and tibia-shaft.

Detailed Description

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The 3D planning of surgeries and their execution with 3D printed templates adapted to the individual patient is an established procedure for elective surgeries such as corrective osteotomies for mal-united fractures. Currently, the planning and production of 3D templates are performed mainly by external companies. The duration until delivery usually exceeds four weeks. Therefore, it is not possible to use them in acute cases (e.g. acute fractures) that need to be treated surgically within a few days.

The most frequent postoperative deformity in long bone shaft fractures is malrotation. In femoral fractures, clinically relevant rotational errors (\>15°) occur in up to 40% of cases after surgical treatment, which either results in a poor clinical outcome or requires revision surgery. In tibial diaphyseal fractures, up to 50% of rotational errors have been reported. The higher the degree of comminution the higher the chances of malrotation postoperatively. Due to the comminuted situation, no reliable bony references exist intraoperatively and the surgeon can only estimate the correct length, axis and, rotation based on the contralateral leg. This ultimately leads to a high number of revision surgeries or poor outcomes. Porcine and human cadaveric feasibility studies conducted by the study team utilizing site 3D planned and printed reduction guides showed excellent accuracy of fracture reduction.

This project aims to apply this technique to the clinical setting by conducting a clinical study. The accuracy of 3D planned surgery performed with surgical guides designed and printed at the point of care will be assessed and the complication rate will be compared to the known literature.

It was hypothesized that the mean deviation between the measured postoperative rotational alignment and planned rotation alignment in patients treated for comminuted fractures of femur- and tibia-shaft treated using 3D printed reposition guides will be less than 5°. Additionally, it was hypothesized that the rate of clinically relevant deviations between postoperative rotational alignment (e.g. 15°) and planned rotation in patients treated for comminuted fractures of femur- and tibia-shaft treated using 3D printed reposition guides will be less than 10%.

Conditions

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Fracture Tibia Fracture Femur Fracture, Comminuted

Keywords

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Femur Tibia Comminuted fracture 3D printing personalized medicine

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Prospective case series
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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3D fracture reposition guide group

Comminuted tibial- or/and femur shaft fractures will be treated using 3D printed patient-specific repositions guides.

Group Type EXPERIMENTAL

Fracture reposition with 3D printed patient specific repositions guides

Intervention Type DEVICE

Comminuted tibial- or/and femur shaft fractures will be treated using 3D printed patient-specific repositions guides.

Interventions

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Fracture reposition with 3D printed patient specific repositions guides

Comminuted tibial- or/and femur shaft fractures will be treated using 3D printed patient-specific repositions guides.

Intervention Type DEVICE

Eligibility Criteria

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Inclusion Criteria

* Age between 18 and 99 years
* Comminuted shaft fracture of tibia or femur
* Intact contralateral tibia or femur
* Patient willing to participate and sign the informed consent
* Clear indication of surgical treatment

Exclusion Criteria

* Refusal to sign the informed consent
* Abnormal contralateral bony anatomy (previous surgeries, poliomyelitis, previous injury, implants)
* Pregnancy
* Acute tumor or previous tumor disease
* Acute infection
Minimum Eligible Age

18 Years

Maximum Eligible Age

99 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Insel Gruppe AG, University Hospital Bern

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Hecker Andreas, MD

Role: PRINCIPAL_INVESTIGATOR

Universitätsklinik für Orthopädische Chirurgie und Traumatologie

Locations

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Universitätsklinik für Orthopädische Chirurgie und Traumatologie

Bern, , Switzerland

Site Status RECRUITING

Countries

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Switzerland

Central Contacts

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Hecker Andreas, MD

Role: CONTACT

Phone: 031 632 21 11

Email: [email protected]

Hess Silvan, MD

Role: CONTACT

Phone: 031 632 21 11

Email: [email protected]

Facility Contacts

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Andreas Hecker, MD

Role: primary

Other Identifiers

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5364

Identifier Type: -

Identifier Source: org_study_id