3D printing technology for the classification of complex distal humerus fractures

Abstract

Background: Distal humerus fractures consider one of the most complex fractures with many different classifications used to determine the severity of the fractures. Recent studies had demonstrated superiority of interobserver reliability of classification over others and some studies showed no superiority of CT over X-ray for the interobserver reliability. The aim of the study was to investigate the three-dimensional (3D) printing technology and its clinical potential in the evaluation of complex distal humerus fractures and use it as a tool for preoperative planning. Methods: Eight different complex distal humerus fractures between 2014 to 2016 in main university hospital were evaluated by four orthopedic observers (resident, senior registrar, consultant and chief of department) using seven different distal humerus fractures classifications. Interobserver agreement was tested by Kappa test. Results: By using the 3D-printing technology between the six different classifications, SOFCOT classification showed the highest interobserver agreement (κ: 0.67). This study also showed that interobserver agreement is double when 3D-printing is used. Conclusions: 3D-printing technology is a better mean for evaluating complex distal humerus fractures between different observers and it can be considered as a tool for preoperative planning.

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