Clinical Efficacy of Three-Dimensional-Printed Pure Titanium Fracture Plates with Locking Screw Systems in Distal Tibia Fractures
<i>Background and Objectives:</i> Distal tibia fractures are high-energy injuries characterized by a mismatch between standard plate designs and the patient’s specific anatomical bone structure, which can lead to severe soft tissue damage. Recent advancements have focused on the developm...
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2025-01-01
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| author | Ji Hye Choi Jun Hyoung Lee Seung Hyeop Lee Woo Young Jang |
| author_facet | Ji Hye Choi Jun Hyoung Lee Seung Hyeop Lee Woo Young Jang |
| author_sort | Ji Hye Choi |
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| description | <i>Background and Objectives:</i> Distal tibia fractures are high-energy injuries characterized by a mismatch between standard plate designs and the patient’s specific anatomical bone structure, which can lead to severe soft tissue damage. Recent advancements have focused on the development of customized metal plates using three-dimensional (3D) printing technology. However, 3D-printed metal plates using titanium alloys have not incorporated a locking system due to the brittleness of these alloys. Therefore, this study aimed to determine whether a locking mechanism can be effectively implemented using 3D-printed pure titanium and further evaluate the clinical outcomes of such implants in patients with distal tibia fractures. <i>Materials and Methods</i>: Between March 2021 and June 2022, nine patients who underwent open reduction and internal fixation for distal tibia fractures using 3D-printed pure titanium plates were enrolled. Pure titanium powder (Ti Gr.2, Type A, 3D Systems, USA) was spread to a thickness of 30 μm and partially sintered using a 500 W laser to produce the 3D-printed metal plates. The locking screws were fabricated using a milling process. Open reduction and internal fixation were performed on the nine patients using 10 customized plates. The clinical efficacy was analyzed using the union rate, and complications, such as infection and skin irritation, were evaluated to ensure a comprehensive outcome assessment. <i>Results:</i> Surgical treatment was successfully performed on nine patients, with nine of ten plates remaining stable and undamaged. However, one patient with neurofibromatosis experienced a fractured metal plate, which necessitated revision surgery using a metal rod. No screw loosening or surgical wound complications occurred. <i>Conclusions:</i> This study showed that 3D-printed pure titanium plates with integrated locking screw systems provide a viable and effective solution for managing distal tibia fractures. Three-dimensional printing and pure titanium show promise for orthopedic advancements. |
| format | Article |
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| institution | Kabale University |
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| language | English |
| publishDate | 2025-01-01 |
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| series | Medicina |
| spelling | doaj-art-bd0beaf1c317402e8b06c487ea5309242025-01-24T13:40:47ZengMDPI AGMedicina1010-660X1648-91442025-01-0161113710.3390/medicina61010137Clinical Efficacy of Three-Dimensional-Printed Pure Titanium Fracture Plates with Locking Screw Systems in Distal Tibia FracturesJi Hye Choi0Jun Hyoung Lee1Seung Hyeop Lee2Woo Young Jang3Department of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, 73 Goryeodae-ro Seongbuk-gu, Seoul 02841, Republic of KoreaDepartment of Orthopedic Surgery, Korea University College of Medicine, Seoul 02841, Republic of KoreaCubelabs, Inc., Seoul 02632, Republic of KoreaDepartment of Orthopedic Surgery, Anam Hospital, Korea University College of Medicine, 73 Goryeodae-ro Seongbuk-gu, Seoul 02841, Republic of Korea<i>Background and Objectives:</i> Distal tibia fractures are high-energy injuries characterized by a mismatch between standard plate designs and the patient’s specific anatomical bone structure, which can lead to severe soft tissue damage. Recent advancements have focused on the development of customized metal plates using three-dimensional (3D) printing technology. However, 3D-printed metal plates using titanium alloys have not incorporated a locking system due to the brittleness of these alloys. Therefore, this study aimed to determine whether a locking mechanism can be effectively implemented using 3D-printed pure titanium and further evaluate the clinical outcomes of such implants in patients with distal tibia fractures. <i>Materials and Methods</i>: Between March 2021 and June 2022, nine patients who underwent open reduction and internal fixation for distal tibia fractures using 3D-printed pure titanium plates were enrolled. Pure titanium powder (Ti Gr.2, Type A, 3D Systems, USA) was spread to a thickness of 30 μm and partially sintered using a 500 W laser to produce the 3D-printed metal plates. The locking screws were fabricated using a milling process. Open reduction and internal fixation were performed on the nine patients using 10 customized plates. The clinical efficacy was analyzed using the union rate, and complications, such as infection and skin irritation, were evaluated to ensure a comprehensive outcome assessment. <i>Results:</i> Surgical treatment was successfully performed on nine patients, with nine of ten plates remaining stable and undamaged. However, one patient with neurofibromatosis experienced a fractured metal plate, which necessitated revision surgery using a metal rod. No screw loosening or surgical wound complications occurred. <i>Conclusions:</i> This study showed that 3D-printed pure titanium plates with integrated locking screw systems provide a viable and effective solution for managing distal tibia fractures. Three-dimensional printing and pure titanium show promise for orthopedic advancements.https://www.mdpi.com/1648-9144/61/1/137titanium alloypure titanium3D printingfractureorthopedic implant |
| spellingShingle | Ji Hye Choi Jun Hyoung Lee Seung Hyeop Lee Woo Young Jang Clinical Efficacy of Three-Dimensional-Printed Pure Titanium Fracture Plates with Locking Screw Systems in Distal Tibia Fractures Medicina titanium alloy pure titanium 3D printing fracture orthopedic implant |
| title | Clinical Efficacy of Three-Dimensional-Printed Pure Titanium Fracture Plates with Locking Screw Systems in Distal Tibia Fractures |
| title_full | Clinical Efficacy of Three-Dimensional-Printed Pure Titanium Fracture Plates with Locking Screw Systems in Distal Tibia Fractures |
| title_fullStr | Clinical Efficacy of Three-Dimensional-Printed Pure Titanium Fracture Plates with Locking Screw Systems in Distal Tibia Fractures |
| title_full_unstemmed | Clinical Efficacy of Three-Dimensional-Printed Pure Titanium Fracture Plates with Locking Screw Systems in Distal Tibia Fractures |
| title_short | Clinical Efficacy of Three-Dimensional-Printed Pure Titanium Fracture Plates with Locking Screw Systems in Distal Tibia Fractures |
| title_sort | clinical efficacy of three dimensional printed pure titanium fracture plates with locking screw systems in distal tibia fractures |
| topic | titanium alloy pure titanium 3D printing fracture orthopedic implant |
| url | https://www.mdpi.com/1648-9144/61/1/137 |
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