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Optimization of Orbital Fracture Fixation Using Low-Cost Patient Specific 3D Printed Models
Lucas A. Dvoracek, Jonathan Lee, Jignesh Unadkat, Joseph Losee, Jesse Goldstein
University of Pittsburgh
2017-02-14
Presenter: Lucas Dvoracek
Affidavit:
This resident has completed the vast majority of the work on this project.
Director Name: Vu Nguyen
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Orbital fractures often require surgical correction to resolve the development of enophthalmos, hypoglobus, and diplopia. Repair plates used to reconstruct one or more walls of the orbit require shaping which cannot be initiated prior to surgery, consumes time intraoperatively, and risks injury to intraorbital structures. The advent of 3D printing technology coupled with 3D reconstructed CT scans has provided surgeons the ability to create models with which to mold fixation plates precisely to match a patient's specific orbital anatomy. Here we present our early experience with these models and their use in optimizing orbital fracture fixation.
Maxillofacial CT scans from pediatric and adult patients with orbital fractures were constructed into 3D models. Both injured-side and mirrored unaffected-side scale models were produced in-house with a 3D printer using polylactic acid filament. The mirrored unaffected-side model was used as an normal template for molding the reconstruction plate, which was then refined by testing the fit within the injured-side model. Plates and models were sterilized using autoclave and ethylene oxide respectively. These plates were then used to reconstruct the orbit intraoperatively, with the sterilized models available as needed.
Three orbital floor fractures and one medial orbital wall fracture were reconstructed. Surgeons noted decreased manipulation of plates intraoperatively to achieve fit, improved surgical efficiency, and reduced operative time. Model production incremental cost was approximately $3.
Orbital fracture reconstruction requires precise shaping of support plates to recreate skeletal anatomy, and the creation of low-cost patient-specific orbital models can enhance the efficiency of these procedures.
