A physical 3D model of the patient’s physeal growth arrest was used to accurately visualize bar location within proximal paediatric tibia. Additional diagnosis of deformation on the tibial plateau confirmed with the use of the physical 3D model.
Investigations showed a small growth arrest bar in the patient’s proximal right tibia and, coincidentally, a similar bar in his left distal femur. CT and MRI scans were performed to try and delineate the extent and exact location of the bar so that surgical excision could be planned accurately through a direct transmetaphyseal window, excising the bar and replacing it with bone cement.
The surgeon was provided with a full-scale model of the proximal tibia and distal femur in clear resin. The ossific bar was then segmented and colored to show and contrast the exact internal position within the anatomy. The surgeon was also equipped with a grey model of the proximal tibia to visualize the surface anatomy.
"The position and surgical planning were greatly enhanced by the manufacture of a 3D transparent model of the tibia showing the exact three-dimensional location of the bar within the tibia. It was used intraoperatively as a guide and safety check as to the position of the surgical bar when the bar was being removed."
Mr. James Ballard
Consultant Orthopedic Surgeon, Royal Belfast Hospital for Sick Children, Northern Ireland
The position and surgical planning were greatly enhanced using the tibia model showing the exact three-dimensional location of the bar within the tibia. In addition, the model also presented another bony deformity on the tibial plateau not seen on conventional imaging. The model was used in surgery as a guide for the position of the growth during resection.
The physical 3D model prints allowed the surgical team to plan the course of treatment for the patient offering a much greater understanding of the location of the pathology within the anatomy. This facilitated the team to plan the surgical location of the operative window to resect the tibial bar more accurately, and provided a guide in theatre during the procedure. The model also provided diagnosis of an additional pathology not found using conventional images.