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3D Printing for Preoperative Assessment and Simulation in Elective Wrist Surgery: Our Experience
Shalin Shaunak, MBBS, MRCS, MSc; N. Briffa, FRCS; Liza Osagie, MBBS, MRCS; Sonja Cerovac, FRCS; Shamim Umarji, FRCS
St. George's Hospital, London, United Kingdom

Introduction: There has been great advances in 3D printing technology and its possible medical applications. The use of this expertise in surgery may significantly advance all aspects of the operative process. We present our initial experiences using 3D modelling for preoperative templating in revision wrist surgery.
Materials and Methods: Data from three patients was included in the study: a revision scaphoid malunion (with broken screw in situ), a distal ulna nonunion with limited bone stock, and a failed wrist fusion. High resolution CT scans were taken at 1 mm per slice; images were exported to a 3D printer. Using CAD/CAM technology a virtual design of the model was generated. Selective laser sintering was used to create a 3D 1:1 scale polyethylene model. Defects were defined, implant type and size determined and and necessary bony resection and fixation aided. Models were created at an average cost of 34 each.
Results: In each clinical case 3 D printing enabled us to accurately recreate the anatomical problem and allow templating as well as actual fixation using our implants. This accurately predicted the likelihood of intraoperative success, or otherwise.
Conclusions: With the push towards “personalised medicine”, 3D scanning and printing is an economical and accurate method of aiding planning for complex surgical procedures. It is especially useful in revision situations or where there are anatomical variations.

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