Three-dimensional printing modeling: application in maxillofacial and hand fractures and resident training
Imaging techniques in reconstructive surgery are of great assistance not only in diagnosis but also in preoperative planning; however, they are often limited to interpreting three-dimensional structures on flat surfaces. Three-dimensional (3D) printing has made it possible to overcome these limitations by allowing the creation of customized 3D anatomical models. We set out to create 3D printed models to demonstrate its application in maxillofacial and hand fractures and resident training.
Ten patients with hand and craniofacial fractures of different types were studied. Computed tomography was performed; the image files were processed digitally, and 3D models were subsequently printed. The quality and accuracy of the obtained models were rigorously evaluated, and the models were then used by plastic surgery teachers and residents in the preoperative planning.
The comparative measurements confirmed that the models are at real scale with a 1:1 ratio; the pre-cast osteosynthesis plates were perfectly matched to the patient’s anatomy intraoperatively, and the lengths of the pre-selected screws were accurate. The anesthetic surgical time was reduced by 20%. Teachers and residents were satisfied with the use of models for clinical discussions of patients and for preoperative planning and the advantages of manipulating physical models were highlighted.
We have created low-cost, good quality, reliable, and accurate 3D printed models for the preoperative planning of reconstructive surgeries of maxillofacial and hand fractures, reducing the operative times and providing a new academic teaching tool in the training of residents of plastic surgery.
Level of Evidence: Level IV, therapeutic study.
KeywordsThree-dimensional printing Computer-assisted surgery Plastic surgery Maxillofacial injuries Fracture fixation Hand injuries
Compliance with ethical standards
Conflict of interest
Jacobo Oscar, Giachero Virginia, Hartwig Denisse, and Mantrana Gustavo declare that they have no conflict of interest.
All procedures in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of retrospective study formal consent from a local ethics committee is not required.
Informed consent was obtained from all individual participants included in the study.
- 3.Jarrahy R, Vo V, Goenjian H, Tabit C et al (2011) Diagnostic accuracy of maxillofacial trauma two-dimensional and three-dimensional computed tomographic scans: comparison of oral surgeons, head and neck surgeons, plastic surgeons, and neuroradiologists. Plast Reconst Surg 127(6):2432–2440CrossRefPubMedGoogle Scholar
- 5.Hull C (1986) Apparatus for production of three-dimensional objects by stereolithography. US Patent 4:575,330Google Scholar
- 7.Crump S (1992) Apparatus and method for creating three-dimensional objects. U.S. Patent 5,121,329Google Scholar
- 9.Ventola C (2014) Medical applications for 3D printing: current and projected uses. Pharm Ther 39(10):704–711Google Scholar
- 31.Chueh J, Wakhloo A, Gounis M (2009) Neurovascular modeling: small-batch manufacturing of silicone vascular replicas. Am J Neuroradiol 30:1159–1164Google Scholar
- 41.Byrne A, Impelmans B, Bertrand V et al (2017) Corrective osteotomy for malunited diaphyseal forearm fractures using preoperative 3-dimensional planning and patient-specific surgical guides and implants. J Hand Surg Am. https://doi.org/10.1016/j.jhsa.2017.06.003
- 49.Danelson K, Gordon E, David L, Stitzel J (2009) Using a three dimensional model of the pediatric skull for pre-operative planning in the treatment of craniosynostosis. Biomed Sci Instrum 45:358–363Google Scholar
- 52.Alvarez C, Carrillo J, Fernández J et al (2006) Avances en equipamiento y sus materiales, un paso hacia el futuro. Cient Dent 3(2):151–156Google Scholar
- 60.Suomalainen A, Stoor P, Mesimaki K, Kontio R (2015) Rapid prototyping modelling in oral and maxilofacial surgery: a two year retrospective study. J Clin Exp Dent 7(5):605–612Google Scholar