3D Printing of Customizable Phantoms to Replace Cadaveric Models in Upper Extremity Surgical Residency Training

Abstract

Medical phantoms are commonly used for training and skill demonstration of surgical procedures without exposing a patient to unnecessary risk. The discrimination of these tissues is critical to the ability of young orthopedic surgical trainees to identify patient injuries and properly manipulate surrounding tissues into healing-compliant positions. Most commercial phantoms lack anatomical specificity and use materials that inadequately attempt to mimic human tissue characteristics. This paper covers the manufacturing methods used to create novel, higher fidelity surgical training phantoms. We utilize medical scans and 3D printing techniques to create upper extremity phantoms that replicate both osseous and synovial geometries. These phantoms are undergoing validation through OSATS training of surgical residents under the guidance of attendings and chief residents. Twenty upper extremity phantoms with distal radius fracture were placed into traction and reduced by first- and second-year surgical residency students as part of their upper extremity triage training. Trainees reported uniform support for the training, enjoying the active learning exercise and expressing willingness for participation in future trials. Trainees successfully completed the reduction procedure utilizing tactile stimuli and prior lecture knowledge, showing the viability of synthetic phantoms to be used in lieu of traditional cadaveric models.

Insights and trends review: the role of three-dimensional technology in upper extremity surgery

“…This produces a 3-D image that can be manipulated on screen, allowing precise evaluation and better understanding of pathologic conditions, such as acute fracture patterns or deformity following nonunion or malunion of fractures. The STL files can then be used to produce a 3-D printed anatomical model for further visual, tactile aid or educational purposes (Farrell et al., 2020; Prsic et al., 2020; Raeker-Jordan et al., 2022) (Figure 1). Following sterilization, these 3-D printed models can be made available in the operating room to facilitate the procedure and assist with implant selection, contouring and positioning.…”

“…The role of 3-D printing in teaching and training has not previously been significantly discussed and described. Current synthetic training models in terms of drilling bone are not completely accurate in terms of feedback and it is now possible to create a bone with either realistic anatomical or pathological structures (Prsic et al., 2020; Raeker-Jordan et al., 2022). Further it is also possible to create models with realistic anatomy not only at bone level but also creating soft tissues (Farrell et al., 2020) (Figure 8).…”