Scheuermann et al: Virtual surgical planning and use of a 3D‐printed, patient‐specific reduction system for minimally invasive plate osteosynthesis of diaphyseal tibial fractures in dogs: A historic case control study
Veterinary Surgery 6, 2024

🔍 Key Findings

  • The study was a historic case-control trial comparing custom 3D-printed VSP-guided MIPO (3D-MIPO) to conventional MIPO (c-MIPO) in dogs with diaphyseal tibial fractures.
  • Surgical time was significantly shorter in the 3D-MIPO group (117 min vs. 151 min; p = .014), and fluoroscopy use was dramatically reduced (11 vs. 37 images; p < .001).
  • All 3D-MIPO reductions were acceptable or near-anatomic; 2 c-MIPO dogs had unacceptable reductions.
  • Tibial length, frontal, and sagittal alignment post-op were similar between groups; no significant difference in anatomic restoration (p > .1).
  • Radiographic union occurred in all dogs by 3 months. Time to union was similar between groups (3D-MIPO: 67 days vs. c-MIPO: 53 days; p = .207).
  • Postoperative complication rate was higher in 3D-MIPO (27% vs. 14%), including 2 major infections requiring implant removal.
  • 3D-MIPO required more pre-op time (~23 hours longer from presentation to surgery; p = .002), partly due to guide printing/sterilization.
  • Improved surgical efficiency and more consistent reductions were noted in the 3D-MIPO group, supporting its clinical utility despite increased pre-op logistics.

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Scheuermann et al: Virtual surgical planning and use of a 3D‐printed, patient‐specific reduction system for minimally invasive plate osteosynthesis of diaphyseal tibial fractures in dogs: A historic case control study
Veterinary Surgery 6, 2024

🔍 Key Findings

  • The study was a historic case-control trial comparing custom 3D-printed VSP-guided MIPO (3D-MIPO) to conventional MIPO (c-MIPO) in dogs with diaphyseal tibial fractures.
  • Surgical time was significantly shorter in the 3D-MIPO group (117 min vs. 151 min; p = .014), and fluoroscopy use was dramatically reduced (11 vs. 37 images; p < .001).
  • All 3D-MIPO reductions were acceptable or near-anatomic; 2 c-MIPO dogs had unacceptable reductions.
  • Tibial length, frontal, and sagittal alignment post-op were similar between groups; no significant difference in anatomic restoration (p > .1).
  • Radiographic union occurred in all dogs by 3 months. Time to union was similar between groups (3D-MIPO: 67 days vs. c-MIPO: 53 days; p = .207).
  • Postoperative complication rate was higher in 3D-MIPO (27% vs. 14%), including 2 major infections requiring implant removal.
  • 3D-MIPO required more pre-op time (~23 hours longer from presentation to surgery; p = .002), partly due to guide printing/sterilization.
  • Improved surgical efficiency and more consistent reductions were noted in the 3D-MIPO group, supporting its clinical utility despite increased pre-op logistics.

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Multiple Choice Questions on this study

In Scheuermann 2024 et al., on 3D-printed reduction systems, how did the complication rates compare between groups?

A. Lower in 3D-MIPO
B. Similar between groups
C. Higher in 3D-MIPO
D. Only in c-MIPO
E. No complications occurred

Answer: Higher in 3D-MIPO

Explanation: The 3D-MIPO group had a 27% complication rate compared to 14% in the c-MIPO group.
In Scheuermann 2024 et al., on 3D-printed reduction systems, what percentage of dogs in the 3D-MIPO group had near-anatomic or acceptable fracture reductions?

A. 100%
B. 87%
C. 60%
D. 73%
E. 95%

Answer: 100%

Explanation: All fractures in the 3D-MIPO group had near-anatomic or acceptable reduction, whereas the c-MIPO group had two unacceptable reductions.
In Scheuermann 2024 et al., on 3D-printed reduction systems, what was the most significant intraoperative imaging difference between 3D-MIPO and c-MIPO groups?

A. More images required in 3D-MIPO
B. Fewer images required in 3D-MIPO
C. CT imaging was used only in c-MIPO
D. Only radiographs were used in 3D-MIPO
E. No significant difference

Answer: Fewer images required in 3D-MIPO

Explanation: The 3D-MIPO group required significantly fewer intraoperative fluoroscopic images (11 vs. 37; p < .001).
In Scheuermann 2024 et al., on 3D-printed reduction systems, which limitation was acknowledged as impacting surgical scheduling in the 3D-MIPO group?

A. Hardware failure of printed guides
B. Inconsistent fracture patterns
C. Lack of CT imaging availability
D. Longer time for virtual surgical planning and printing
E. Prolonged anesthesia in all cases

Answer: Longer time for virtual surgical planning and printing

Explanation: Pre-op planning and guide production caused a ~23 hour delay from presentation to surgery in the 3D-MIPO group.
In Scheuermann 2024 et al., on 3D-printed reduction systems, what was the primary benefit of the 3D-MIPO technique compared to conventional MIPO?

A. Lower complication rate
B. Reduced need for anesthesia
C. Improved fracture healing scores
D. Significantly shorter surgical duration
E. Fewer implant types required

Answer: Significantly shorter surgical duration

Explanation: The 3D-MIPO group had a mean surgical time 34 minutes shorter than the conventional MIPO group.

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