Three-dimensional printing modeling: application in maxillofacial and hand fractures and resident training

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.