By Otto Madelung – O. W. Madelung: Die spontane Subluxation der Hand nach Vorne. Verhandlungen der deutschen Gesellschaft für Chirurgie, Berlin 7: 259-276 (1878)

The flexibility, ease of use, cost efficiency, and precision of 3D printing has turned it into a power player in the medical world. Every day we read new stories about its use in medicine ranging from the now commonplace to the particularly tricky; there seems to be no corner of medical practice that it has left untouched. Now it’s in the headlines again for having passed another goalpost. This past week marks the first time that 3D printing has been used in orthopedic surgery in the country of Israel.

The patient, a thirteen-year-old Israeli girl, underwent surgery at Jerusalem’s Shaare Zedek Medical Center, to correct a problem in her right hand that resulted from Madelung’s deformity. The condition — named for Otto Wilhelm Madelung, the German physician who first provided its comprehensive, clinical description — is characterized by malformed bones in the wrists, either one or both, that can both be a hindrance to movement and cause radiating pain. Madelung’s deformity can be associated with dwarfism and X-chromosome mutations, though not exclusively.

In this case, the girl arrived at the hospital experiencing pain and restricted movement, and the decision was made to operate after CT scans showed the presence of two distortions in her right arm and one in the left arm. The surgical procedure calls for the creation of an incision in the axis of the bone, followed by the bone’s reconstruction, and then finally ensuring that the bone remains fixed in its new form.

Innovation Lab at the 7th annual Exponential Medicine Conference. [Photo: David Fratto / Media Posse]

In order to aid the surgeons in their creation of the four necessary incisions and in the fixation of the repaired bone, the surgical team worked with Synergy3DMed, a company with a proven track record in the production of 3D printed pieces for surgical interventions. The capability of this technology to aid in medical interventions first came to the team’s attention when it was used in Israel to create the tools required to remove a cancerous growth from a young girl’s kidney. Having seen the success in an operation so close to home, Dr. Gershon Singer, head of the Hand Surgery Unit, decided it was just the tool he needed to perform the operation. As Dr. Singer explained:

“We performed four incisions at very precise angles, including the placement of three screws that entered perfectly without deviation from the joint or incision. This is very difficult to complete without 3D printing.”

In order to prepare the 3D printed component, the girl’s arm was scanned in order to create a digital model that would allow the medical team to analyze the areas of concern from all angles. After careful study, planning for the needed surgical guide and brace were undertaken. The information for the form of the surgical tool was then passed on to the company so that they could build the appropriate file to be printed and ready for use in the operating room. The guide was then placed on the arm during surgery using magnets, providing invaluable assistance in the creation of a nearly foolproof procedure.

The surgery on the girl’s right arm having gone successfully, plans are now underway to correct the deformity in her left arm. In the meantime, the girl reports increased movement capability and a reduction in pain, making it likely that this will become the new standard method for undertaking procedures such as this one.

What do you think of this news? Let us know your thoughts; join the discussion of this and other 3D printing topics at 3DPrintBoard.com.

[Source: The Jerusalem Post]

 

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