Use of 3D printing as a simulation tool for trauma surgery of the pelvis

Abstract

Objective: Fractures of the pelvis are serious pathologies that can be life-threatening. Surgical treatment of complex fractures is difficult, due to the proximity of neighboring vessels and organs. Our goal was to create a practical educational simulation model printed in 3 dimensions (3D) from CT scans images of a patient who had a complex fracture of the pelvis. Method: Preoperative CT scan of a right hemi-pelvic fracture was modeled using an open source softwares such as Horos® and Meshmixer®. The free software Cura® made it possible to print bone elements and pelvic vessels using Fused Deposition Modeling technology (FDM). Negative molds were printed to pour liquid latex to represent skin, muscles and the bladder. All these elements were reassembled to create a model faithful to the patient's anatomy. Results: A first model comprising 33 objects (1:2 scale) was produced after 39 h of cumulative printing. Three approaches were feasible among ilio-inguinal, posterior and tri-radiated approaches. Six models of plates were used to maintain fracture reduction. The external iliac vessels and the iliac psoas muscle in latex could be reclined to access the fragments of the internal iliac fossa. Conclusion: Our model seems to improve the 3D vision of the anatomical region of the pelvis as a function of the recumbency. This prototype demonstrated the feasibility of using CT scans for the creation of a realistic 3D models. A new 1:1 scale model would create a real simulator for training surgical students who could practice dealing with this complex anatomical region.

Keywords

• Fracture
• Pelvis
• 3D printing
• 3D modeling