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The efficacy of 3D printing-assisted surgery for traumatic fracture: a meta-analysis
  1. Liang Xiong1,2,
  2. Xiaoyang Li1,
  3. Hui Li1,
  4. Zhuoyuang Chen1,
  5. Tao Xiao1
  1. 1 Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, China
  2. 2 Bioengineering Laboratory, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA
  1. Correspondence to Dr Tao Xiao, Orthopedics, The Second Xiangya Hospital of Central South University, Changsha 410011, China; xiaotaoxyl{at}


Background Recent years have witnessed a rapid development of three-dimensional (3D) printing technology applied in orthopaedic surgery. To be assisted by 3D printing is a potent method to realise accurate and individualised operation. The objective of this meta-analysis was to assess the efficacy of 3D printing technology in the management of trauma fractures.

Methods PubMed, Embase and the Cochrane Library were systematically searched up until January 2019 to identify relevant studies. All clinical studies comparing conventional surgery and 3D printing-assisted surgery in the management of orthopaedic trauma were obtained. The meta-analysis was performed with RevMan V.5.3 software.

Results Four randomised controlled trials, four retrospective comparative studies and two prospective comparative studies involving 521 patients were included. Compared with conventional surgery, 3D printing-assisted surgery leads to shorter operation duration (mean difference (MD) −16.59 (95% CI −18.60 to –14.58), p<0.001), less intraoperative blood loss (standardised mean difference (SMD) −1.02 (95% CI –1.25 to –0.79), p<0.001) and fewer intraoperative fluroscopies (SMD −2.20 (95% CI –2.50 to –1.90), p<0.001). However, 3D printing-assisted surgery leads to longer hospital stay (MD 2.51 (95% CI 0.31 to –4.72), p=0.03). No significant results were found regarding fracture healing time, the rate of excellent and good outcomes, anatomical reduction and complications.

Conclusions These results suggest that 3D printing-assisted surgery outperforms conventional surgery in the management of orthopaedic trauma fractures with shorter operation duration, less intraoperative blood loss and fewer intraoperative fluoroscopies.

  • additive manufacturing
  • fracture
  • meta-analysis
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  • Contributors LX planned the study and wrote the manuscript. LX and XL conducted the statistical analysis and revised the manuscript. ZC performed statistical analysis. HL examined the data and included studies. TX supervised the study.

  • Funding Sources of funding for this study include the National Natural Science Foundation of China (grant number 81502332) and The 2019 Research Project of Human Health Commission (grant number 2019162).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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