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ISSN 2007-087X (Print)
Órgano Oficial de la Sociedad Mexicana de Ortopedia Pediátrica

2020, Number 1-3

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Rev Mex Ortop Ped 2020; 22 (1-3)

Three-dimensional biomodels for the surgical treatment of talo-calcaneal coalitions

Masquijo J, Ferreyra A, Allende V

Language: Spanish
References: 16
Page: 11-15
PDF size: 253.56 Kb.


ABSTRACT

Introduction: Surgical treatment of talocalcaneal coalitions (TCC) is challenging due to the high variability in clinical presentation and complex anatomy of the subtalar joint. The aim of this study is to describe our experience with the use of three-dimensional printing for pre-operative planning of TCCs. Material and methods: We prospectively studied patients with TCC treated between January 2017 to January 2019. Three-dimensional reconstructions were performed from tomographic images using the Mimics® 16 Materialize program. Preoperative planning was carried out with the 3-matic® Medical version 8 Materialize program. Subsequently, biomodels were manufactured in PLA (polylactic acid) with an FDM technology printer (fused deposition modeling) Ultimaker 3. The digital files were prepared for manufacturing with the Ultimaker Cura 3.6 program. Results: Five consecutive patients (6 feet) were evaluated. Average age was 13.2 ± 1.3 years. Five feet had not received prior surgical treatment, and one foot had a failed previous resection. The models were obtained at real scale (1:1 ratio). The impression of the biomodels allowed to determine precisely the involvement of the posterior facet, plane of resection of the coalition, magnitude of hindfoot deformity and, if necessary, to plan the osteotomies for realignment. Four feet had resection of the coalition associated to realignment, one foot had isolated resection, and one had a revision surgery (coalition resection). At the last follow-up, all patients were asymptomatic, and satisfied with the procedure. No patient required additional surgeries. Conclusion: The use of three-dimensional biomodels facilitates pre-surgical planning, allowing virtual planning to be translated into a more tangible one. Potentially, better quality planning could reduce surgery time and allow a more accurate correction of the deformity. Comparative studies are required to determine if these hypotheses are correct.


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EVIDENCE LEVEL

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