3D printing innovation: New insights into upper extremity surgery planning

Fillat-Gomà, Ferràn; Marcano-Fernández, Francesc; Coderch-Navarro, Sergi; Martínez-Carreres, Laia; Berenguer, Alex

doi:10.1016/j.injury.2021.01.048

Cited by 17 publications

(23 citation statements)

References 11 publications

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“…However, the exposure level of intraoperative fluoroscopy is approximately 20–200 mSv per minute [ 25 ], but only 0.07 mSv for the CT scanning of ankle [ 26 ], and it would be decline even further by reducing the volume areas [ 27 ]. Furthermore, the decrease in intraoperative use of the C-arm with the application of virtual simulation and PSI was confirmed [ 20 , 28 ], as well as the simplification of surgical procedures and reducing in surgical time [ 15 , 16 , 28 ], therefore, we believe that the benefits outweigh the injuries. Another limitation was the time and economic cost associated with 3D design and printing.…”

Section: Discussionmentioning

confidence: 95%

“…Furthermore, our technique was different from the others in that we took the implant into account during design procedures, therefore, the plate could act as a reduction guide, and the placement of the implant and the insertion of locking screws could be simultaneously guided by the PSI with no need for an additional reduction guide in the operation. In addition to the benefits mentioned, we printed real-scale models for preoperative simulation and intraoperative reference, which provided both tactile and visual feedback [ 16 , 24 ]. This technique also enhanced the surgeon’s understanding of the deformity and subsequent surgery, and provided practice opportunities for the residents and training fellows [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

“…In addition to the benefits mentioned, we printed real-scale models for preoperative simulation and intraoperative reference, which provided both tactile and visual feedback [ 16 , 24 ]. This technique also enhanced the surgeon’s understanding of the deformity and subsequent surgery, and provided practice opportunities for the residents and training fellows [ 16 ]. Finally, it enabled us to preoperatively verify the position of the implants, and design the shape of the bone graft to increase the accuracy of certain procedures.…”

Section: Discussionmentioning

confidence: 99%

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Intra-articular opening wedge osteotomy for varus ankle arthritis with computer-assisted planning and patient-specific surgical guides: a retrospective case series

Zhao

et al. 2022

BMC Musculoskelet Disord

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Background Computer-assisted preoperative planning, combined with PSI has become an effective technique for treating complex limb deformities. The purpose of this study was to evaluate the efficacy and safety of the novel technique in corrective osteotomy for intra-articular varus ankle deformities associated with osteoarthritis and ankle instability. Methods Nineteen patients with intra-articular varus ankle arthritis were reviewed between April 2017 and June 2019, including ten men and nine women with a mean age of 58.3 ± 9.9 years (range, 38 to 76 years). All patients underwent intra-articular opening wedge osteotomy assisted by 3D virtual planning and PSI. Weight-bearing radiographs were used to assess the radiographic results, including TAS angle, TT angle, TMM angle, TC angle, TLS angle, opening-wedge angle, and wedge height. Functional outcomes were assessed by the AOFAS score, VAS score, and ROM of the ankle. Results The average follow-up time was 32.2 ± 9.0 months (range, 22 to 47 months). The average union time was 4.4 ± 0.9 months (range, 3.0 to 6.5 months). The TAS angle significantly changed from 84.1 ± 4.6° preoperatively to 87.7 ± 3.1° at the 1-year follow-up and 86.2 ± 2.6° at the latest follow-up. Similarly, the TT angle, TMM angle and TC angle changed significantly at the 1-year follow-up compared with the preoperative assessment and remained stable until the last follow-up. However, the TLS was not corrected significantly. The postoperative obtained opening-wedge angle, and wedge height showed no significant change with preoperative planning. The overall complication rate was 15.8%. The mean VAS score improved from 5.3 ± 0.6 to 2.7 ± 0.7. The mean AOFAS score improved from 56.2 ± 7.6 to 80.6 ± 4.6. However, the ROM showed no significant change. Conclusions Accurate correction and satisfactory functional recovery were attained with computer-assisted planning and PSI in the corrective osteotomy of intra-articular varus ankle deformities.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Intra-articular opening wedge osteotomy for varus ankle arthritis with computer-assisted planning and patient-specific surgical guides: a retrospective case series

Zhao

et al. 2022

BMC Musculoskelet Disord

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“…2 and 3 ). Also, based on advancements in 3D printing technology, surgical treatment with the aid of 3D printing has been introduced [ 6 , 43 , 44 ].…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…van Doremalen et al [ 43 ] adjusted the plate preoperatively with 3D printed models and suggested preoperative preparation with 3D printed models may reduce implant removal caused by plate-related discomfort. Fillat-Gomà et al [ 44 ] showed improvement and enhanced surgical planning not only in clavicle fractures but also in other upper extremity fractures by 3D printing technology. They also applied the plate on a 3D-printed clavicle model and choose the best fitting plate with optimal stability.…”

Section: Surgical Treatmentmentioning

confidence: 99%

Current concepts in the treatment of midshaft clavicle fractures in adults

Song

Kim

2021

Clin Shoulder Elbow

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Midshaft clavicle fractures are the most common fracture of the clavicle accounting for 80% of all clavicle fractures. Traditionally, midshaft clavicle fractures are treated with conservative treatment even when prominent displacement is observed; however, recent studies revealed that nonunion or malunion rate may be higher with conservative treatment. Moreover, recent studies have shown better functional results and patient satisfaction with surgical treatment. This review article provides a review of clavicle anatomy, describes the current clavicle fracture classification system, and outlines various treatment options including current surgical options for clavicle fracture in adults.

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Three-dimensional-printed patient-specific instrumentation is an accurate tool to reproduce femoral bone tunnels in multiple-ligament knee injuries

Fernández-Poch

Fillat-Gomà

Martínez-Carreres

et al. 2023

International Orthopaedics (SICOT)

Self Cite

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Purpose Multiple-ligament knee reconstruction techniques often involve the creation of several bone tunnels for various reconstruction grafts. A critical step in this procedure is to avoid short tunnels or convergences among them. Currently, no specific template guide to reproduce these angulations has been reported in the literature, and the success of the technique still depends on the experience of the surgeon. The aim of this study is to analyze the accuracy and reliability of 3D-printed patient-specific instrumentation (PSI) for lateral and medial anatomical knee reconstructions. Methods Ten cadaveric knees were scanned by computed tomography (CT). Using specific computer software, anatomical femoral attachments were identified: (1) on the lateral side the lateral collateral ligament (LCL) and the popliteal tendon (PT) and (2) on the medial side the medial collateral ligament (MCL) and the posterior oblique ligament (POL). Four bone tunnels were planned for each knee, and PSI with different directions were designed as templates to reproduce the planned tunnels during surgery. Twenty 3D-printed PSI were used: ten were tailored to the medial side for reconstructing MCL and POL tunnels, and the other ten were tailored to the lateral side for reconstructing LCL and PT tunnels. Postoperative CT scans were made for each cadaveric knee. The accuracy of the use of 3D-printed PSI was assessed by superimposing post-operative CT images onto pre-operative images and analyzing the deviation of tunnels performed based on the planning, specifically the entry point and the angular deviations. Results The median entry point deviations for the tunnels were as follows: LCL tunnel, 1.88 mm (interquartile range (IQR) 2.2 mm); PT tunnel, 2.93 mm (IQR 1.17 mm); MCL tunnel, 1.93 mm (IQR 4.26 mm); and POL tunnel, 2.16 mm (IQR 2.39). The median angular deviations for the tunnels were as follows: LCL tunnel, 2.42° (IQR 6.49°); PT tunnel, 4.15° (IQR 6.68); MCL tunnel, 4.50° (IQR 6.34°); and POL tunnel, 4.69° (IQR 3.1°). No statistically significant differences were found in either the entry point or the angular deviation among the different bone tunnels. Conclusion The use of 3D-printed PSI for lateral and medial anatomical knee reconstructions provides accurate and reproducible results and may be a promising tool for use in clinical practice.

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3D printing innovation: New insights into upper extremity surgery planning

Cited by 17 publications

References 11 publications

Intra-articular opening wedge osteotomy for varus ankle arthritis with computer-assisted planning and patient-specific surgical guides: a retrospective case series

Intra-articular opening wedge osteotomy for varus ankle arthritis with computer-assisted planning and patient-specific surgical guides: a retrospective case series

Current concepts in the treatment of midshaft clavicle fractures in adults

Three-dimensional-printed patient-specific instrumentation is an accurate tool to reproduce femoral bone tunnels in multiple-ligament knee injuries

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