Patient-specific implants are accurate and cost-effective for blow-out fracture reconstruction: a retrospective case-control study.

BACKGROUND

The volume of the bony orbit increases in facial trauma with a blow-out fracture and may lead to enophthalmos and double vision. The orbit's volume can be restored surgically. The authors aimed to determine the most accurate and cost-effective method for reconstructing blow-out fractures: virtual surgical planning (VSP) combined with patient-specific implants (PSI) or standard titanium stock implants.

MATERIALS AND

METHODS

The authors conducted a retrospective study of patients who sustained a blow-out fracture requiring surgical reconstruction. Patients were categorized into two groups: the PSI group (n = 13) and the standard titanium stock implant group (n = 36). The primary aim was to analyze the total cost in each group, with a secondary aim to ensure volumetric restoration was achieved. Postoperative volume, operation time, need for reoperation, surgical and inpatient costs, and cost-effectiveness were calculated. The data were analyzed with Shapiro-Wilk, Mann-Whitney U test, and Fisher's exact test, using a significance level of 0.05.

RESULTS

The operation time was significantly shorter in the PSI group than in the stock implant group, with an average of 89.77 and 122.69 min, respectively (p = 0.008), resulting in lower total costs in the PSI group. The PSI group had better postoperative volumetric restoration than the stock implant group compared to the contralateral side (p = 0.01). Four out of 36 patients (11%) needed reoperation in the stock implant group.

CONCLUSIONS

Preliminary results suggest that PSI requires a shorter operation time and is therefore cost-effective without compromising surgical outcomes.