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Percutaneous Fracture Reduction of Cadaveric Feline Tibiae (Gap Model) Using Computed Tomography, Computer Design
Felix Marten1, Sabine Kramer1, Nikolaus Huels1
1Klinik für Kleintiere, Stiftung Tierärztliche Hochschule Hannover, Hannover, Germany.
Objective:
This study aimed to evaluate percutaneous reduction of feline tibial fractures (gap model) using a three-dimensional-printed external skeletal fixator (jig) and assess the contralateral tibia as a template for virtual planning.
Study Design:
Postmortem computed tomography (CT) was performed on 11 skeletally mature feline specimens. A mid-shaft tibial fracture gap model was created, followed by the placement of two lead-marked K-wires per fragment. The DICOMS images of repeated CT scans were imported into the virtual planning software to design a specimen-specific jig using the contralateral side as a template. The jig housed the leads and acted as a connecting bar to facilitate fracture reduction. Post-procedure radiography and CT were performed to evaluate fracture reduction.
Results:
A total of 22 tibiae of 11 cats were reduced using a jig. There was an average difference of <1 mm in terms of tibial length and <5 degrees in joint angulations and in terms of rotation when comparing the post-procedure tibia with the initial CT/radiograph (p < 0.05). The alignment was considered anatomical in 16 of 21 limbs and acceptable in 5 of 21 limbs. Pin loosening occurred in one case during the jig process.
Conclusion:
Temporary fracture reduction using the three-dimensional-printed jig was feasible and accurate in 21 of the 22 procedures. When using the contralateral tibia as a template, an asymmetry of up to 6% in terms of joint angulations should be considered.
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