RESUMEN
3D printing has been used in the medical field since the beginning of the 21st century. Over the years, it has been democratized and has become an accessible tool at almost no cost, provided that a 3D printer is available. The surgeon can thus easily integrate it into his practice and techniques in the operating room, provided that he learns to use 3D image processing software. In order to illustrate the whole process, from the genesis and processing of the 3D image to its application in the operating room, we describe the case of a patient with a left auricle amputation, whose reconstruction was guided by a 3D model printed from his right ear.
Asunto(s)
Pabellón Auricular , Procedimientos de Cirugía Plástica , Cirugía Plástica , Masculino , Humanos , Impresión Tridimensional , Pabellón Auricular/cirugía , Imagenología TridimensionalRESUMEN
The present study aimed to develop a reliable dynamic measurement technique, which can be used directly in the outpatient setting, based on dorsal subluxation of the scaphoid on scaphoid shift test. This study was designed to evaluate feasibility and to quantify dorsal subluxation of the scaphoid in relation to the lunate. Based on a scaphoid shift test under ultrasonography, a standardized 3D test model was developed to measure subluxation. Sagittal subluxation ranged between 0 and 6 mm, as checked on the implemented scale. Four hand surgeons trained in ultrasonography (experience level II-V) performed blinded measurements (total of 52, n = 13 per investigator) with a standardized measurement protocol. Dorsal subluxation of the scaphoid was measured in relation to the lunate. Interobserver reliability on intraclass correlation coefficient (ICC) was excellent, at 0.97 (95% confidence interval, 0.930-0.992). Mean overall absolute measurement error was 0.27 mm ± 0.21. Dorsal subluxation of the scaphoid can thus be accurately measured on ultrasound with excellent interobserver reliability, quantifying and improving clinical assessment of scapholunate instability.
Asunto(s)
Inestabilidad de la Articulación , Ligamentos Articulares , Estudios de Factibilidad , Humanos , Inestabilidad de la Articulación/cirugía , Ligamentos Articulares/cirugía , Reproducibilidad de los Resultados , UltrasonografíaRESUMEN
Legislation concerning workload of surgical trainees and pressure to reduce learning curves have forced us reconsider surgical training. Our goal was to evaluate a synthetic procedural simulator for teaching open reduction and internal fixation (ORIF) of distal radius fractures (DRF). Twenty surgeons used a synthetic procedural simulator (Wristsim®) made by 3D printing for ORIF of DRF with a volar plate (Newclip Technics®). The evaluation consisted of grading the simulator's realism compared to the surgeons' own experience with surgery on cadavers. The Wristsim® was graded 5.10/10, compared to 8.18/10 for the cadaver specimen for introduction of the plate under pronator quadratus. For fracture reproduction, Wristsim® scored 6.40/10, with the cadaver specimen scoring 7.15/10. For fracture reduction, Wristsim® scored 5.62/10, with the cadaver specimen scoring 7.38/10. Plate application was scored 7.05/10 for Wristsim® and 8.23/10 for the cadaver. Drilling was scored 6.60/10 for the Wristsim® and 8.23/10 for the cadaver. Screw fixation was scored 7.40/10 for the Wristsim® and 8.12/10 for the cadaver. Our results demonstrated that Wristsim® is still inferior to a cadaver specimen for teaching ORIF by volar plating of DRF. A new model of Wristsim® is being developed that will address shortcomings in pronator quadratus thickness, passive ROM in flexion/extension and bone size.