Use of Three-dimensional Printing for Tibial Pilon Fracture Diagnosis and Treatment.

 To evaluate whether three-dimensional (3D) printing increases agreement in the classification of tibial pilon fractures.  Orthopedists and traumatologists reviewed radiographs, computed tomography scans with 3D reconstruction, and prototyping 3D printing, and classified the fractures based on the Rüedi-Allgöwer and Arbeitsgemeinschaft für Osteosynthesefragen (AO, Association for the Study of Internal Fixation) Foundation/Orthopedic Trauma Association (AO/OTA) classification systems. Next, data evaluation used Kappa agreement coefficients.  The use of the 3D model did not improve agreement for tibial pilon fractures regarding the treatment proposed by the groups. Regarding the classification systems, the agreement only improved concerning the AO/OTA classification when the 3D model was used in the assessment by the foot and ankle specialists.  Although 3D printing is statistically relevant for surgeons specializing in foot and ankle, its values remain lower than optimal.