Preoperative Simulation and Three-Dimensional Model for the Operative Treatment of Tibiofibular Diaphyseal Fracture: A Randomized Controlled Clinical Trial

J Invest Surg. 2025 Dec;38(1):2463351. doi: 10.1080/08941939.2025.2463351. Epub 2025 Feb 16.

Abstract

Background: In order to ascertain the safety and therapeutic efficacy of preoperative simulation in conjunction with three-dimensional (3D) printing modalities for the surgical management of tibiofibular diaphyseal fractures. We postulate that preoperative simulation and three-dimensional (3D) printing techniques have a significant impact on reducing the mean operative time, diminishing intraoperative blood loss, and decreasing the frequency of fluoroscopic.

Material and methods: Sixty patients with tibiofibular diaphyseal fracture were divided into the conventional surgery group (n = 30) and the 3D printing group (n = 30). In the 3D printing group, preoperative equal-ratio fracture models prepared using the 3D printing technique were used to perform preoperative simulation, guide the real surgical operation, examine implant reduction and placement as well as preoperative plate/screw size. The operation time, intraoperative bleeding, frequency of fluoroscopies, Visual Analog Scale (VAS), and Johner-Wruhs Scale were recorded.

Results: The operation time, blood loss, and the frequency of fluoroscopy during operation in the group with preoperative simulation and 3D printing were less than that in the conventional surgery group (p < 0.001). Meanwhile, the Visual Analog Scale (VAS) and Johner-Wruhs Scale were also improved in both groups.

Conclusion: The findings indicated that preoperative simulation and three-dimensional (3D) printing may facilitate the treatment of tibiofibular diaphyseal fractures, potentially enhancing preoperative planning and contributing to the precision and personalization of the surgical procedure. Thus, the application of this technology possesses considerable promise for future utilization in clinical practice.

Trial registry: Name of the registry: This study was registered in the Chinese Clinical Trial Registry; Trial registration number: ChiCTR2100052379.

Keywords: Three-dimensional printing; preoperative simulation; surgical treatment; tibiofibular diaphyseal fracture.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Blood Loss, Surgical / prevention & control
  • Blood Loss, Surgical / statistics & numerical data
  • Bone Plates
  • Diaphyses / diagnostic imaging
  • Diaphyses / injuries
  • Diaphyses / surgery
  • Female
  • Fibula* / diagnostic imaging
  • Fibula* / injuries
  • Fibula* / surgery
  • Fluoroscopy / statistics & numerical data
  • Fracture Fixation, Internal* / adverse effects
  • Fracture Fixation, Internal* / instrumentation
  • Fracture Fixation, Internal* / methods
  • Humans
  • Male
  • Middle Aged
  • Operative Time
  • Preoperative Care* / methods
  • Printing, Three-Dimensional*
  • Surgery, Computer-Assisted* / methods
  • Tibial Fractures* / diagnostic imaging
  • Tibial Fractures* / surgery
  • Treatment Outcome
  • Young Adult