{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T23:03:59Z","timestamp":1784070239938,"version":"3.55.0"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,15]],"date-time":"2026-07-15T00:00:00Z","timestamp":1784073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"\n Background<\/jats:title>\n Optimal fixation for pelvic and acetabular fractures remains challenging due to competing demands for stability and minimally invasive surgery. This study combined finite element (FE) modeling and a retrospective clinical analysis to compare three fixation strategies.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A three-dimensional FE model of a representative both-column acetabular fracture was constructed to compare cannulated screw-only, plate-only, and combined cannulated screw\u2013plate fixation under simulated standing and sitting conditions. Clinically, patients with acetabular fractures treated between November 2021 and May 2023 were retrospectively grouped into 3D-printed guide plate\u2013assisted cannulated screw plus plate (\n n<\/jats:italic>\n \u2009=\u20098), conventional cannulated screw plus plate (\n n<\/jats:italic>\n \u2009=\u200914), and plate-only fixation (\n n<\/jats:italic>\n \u2009=\u200912). Perioperative outcomes, postoperative complications, and 3-month hip function were analyzed with multivariable adjustment.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n FE analysis showed higher stress and displacement under sitting than standing across all constructs, with combined cannulated screw\u2013plate fixation providing better fracture-line displacement control than screw-only fixation, particularly under sitting conditions. Clinically, after multivariable adjustment, the 3D-printed guide group had significantly shorter operative time than the plate-only group and the conventional screw plus plate group (\u221256.15\u2005min,\n P<\/jats:italic>\n \u2009=\u20090.048; \u221268.46\u2005min,\n P<\/jats:italic>\n \u2009=\u20090.031, respectively), lower intraoperative blood loss than the plate-only group (\u2212575.48\u2005mL,\n P<\/jats:italic>\n \u2009=\u20090.001), and shorter incision length than the plate-only group (\u22127.94\u2005cm,\n P<\/jats:italic>\n \u2009=\u20090.004). Both the 3D-printed guide group and the conventional screw plus plate group showed significantly lower total hospitalization costs than the plate-only group (\u221239,944.29 RMB,\n P<\/jats:italic>\n \u2009=\u20090.040; \u221232,527.55 RMB,\n P<\/jats:italic>\n \u2009=\u20090.048, respectively). No significant adjusted differences were observed in complication risk, 3-month hip function, or hospital length of stay.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Combined cannulated screw\u2013plate fixation provides superior biomechanical stability for complex acetabular fractures, while patient-specific 3D-printed guide plate significantly improve perioperative efficiency without compromising short-term safety or functional recovery.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fsurg.2026.1797007","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T22:10:18Z","timestamp":1784067018000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical efficacy and biomechanical analysis of 3D-printed guide plate\u2013assisted cannulated screw fixation compared with conventional fixation in complex acetabular fractures"],"prefix":"10.3389","volume":"13","author":[{"given":"Chaoqiang","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Sports Medicine, The First Affiliated Hospital of Fujian Medical University","place":["Fuzhou, Fujian, China"]},{"name":"Department of Orthopedics, Mindong Hospital Affiliated to Fujian Medical University","place":["Fu\u2019an, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyu","family":"He","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mindong Hospital Affiliated to Fujian Medical University","place":["Fu\u2019an, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mindong Hospital Affiliated to Fujian Medical University","place":["Fu\u2019an, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueli","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Mindong Hospital Affiliated to Fujian Medical University","place":["Fu'an, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mindong Hospital Affiliated to Fujian Medical University","place":["Fu\u2019an, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mindong Hospital Affiliated to Fujian Medical University","place":["Fu\u2019an, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caosheng","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mindong Hospital Affiliated to Fujian Medical University","place":["Fu\u2019an, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huimei","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mindong Hospital Affiliated to Fujian Medical University","place":["Fu\u2019an, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, The First Affiliated Hospital of Fujian Medical University","place":["Fuzhou, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiping","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Mindong Hospital Affiliated to Fujian Medical University","place":["Fu\u2019an, Fujian, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1547","DOI":"10.1007\/s00402-021-03873-5","article-title":"Factors associated with mortality in older patients sustaining pelvic or acetabular fractures","volume":"142","author":"Harrison","year":"2022","journal-title":"Arch Orthop Trauma Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"101049","DOI":"10.1016\/j.ijotn.2023.101049","article-title":"Epidemiology of acetabular fractures in elderly patients and the effect of various management options on the outcomes. A comprehensive narrative review","volume":"53","author":"Khalifa","year":"2024","journal-title":"Int J Orthop Trauma Nurs"},{"key":"B3","doi-asserted-by":"publisher","first-page":"e3","DOI":"10.2106\/JBJS.ST.18.00034","article-title":"Open reduction and internal fixation of acetabular fractures using the modified stoppa approach","volume":"9","author":"Tannast","year":"2019","journal-title":"JBJS Essent Surg Tech"},{"key":"B4","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.medengphy.2021.02.002","article-title":"Biomechanical analysis of fixation methods for acetabular fractures: a review","volume":"89","author":"Ferrante","year":"2021","journal-title":"Med Eng Phys"},{"key":"B5","first-page":"e432","article-title":"Navigation and intraoperative imaging in pelvic and acetabular trauma","volume-title":"OTA Int","author":"Hutchings","year":"2025"},{"key":"B6","doi-asserted-by":"publisher","first-page":"60","DOI":"10.1177\/22104917231191806","article-title":"The use of 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