3d TECHNOLOGY-ENABLED CORRECTION OF PAEDIATRIC DEFORMITY: BYTE TO BONE, PART 1. PLANNING AND 3D PRINTING

3D technology is a digital prototyping technology based on a 3d information, processing, and prototyping object & additive layering principle integrating with (CAD) computer-aided designs. Because of the advantages of 3D information processing, planning, and printing, it has become an important tool in Orthopaedic surgery and is hence effective in paediatric deformity correction to achieve anatomical multiaxial correction by precision, reduced surgical stress, time, and best patient outcomes. 3D printing is a form of manufacturing process where an object is created in three dimensions in a layered fashion from a digital model in a short span of time. Medical rapid prototyping and 3D printing are ushering in a new revolution in healthcare by offering ingenious, innovative, and personalized solutions to complex problems. Paediatric deformity being complex, pre-operative planning a jig enables multiaxial correction to precision and precise implant fixation. 3-D planning of the osteotomy, designed and printed patient-specific surgical guide (PSSG) will solve our three major challenges. First, to be able to take precise cuts as planned pre-operatively, second to have precise implant placement and third to correct Limb length discrepancy while fixing the osteotomy accurately. The steps for planning and execution of deformity correction by osteotomy using 3-D technology include Planning: The first step is the 3-D Planning of the osteotomy and designing and printing of the surgical guide. The CT Image files are processed by segmentation, smoothing, and conversion to stereolithography (STL) format. The osteotomy is virtually executed, a virtual implant is placed and drill holes for the implant and planes for the osteotomy are defined. The deformity is recreated using the principles of reverse engineering and patient patient-specific guide is designed. Practice: The surgery steps are carried out using the 3-D printed model. The levels of osteotomy, implant positions, and final correction confirming anatomical restoration are confirmed. Performance: Execution of the surgery with the help of the 3d printed polymer-based patient-specific surgical guide (PSSG). This guide is used during the surgery for osteotomies and implant placement. The entire process of planning, practice, and execution of surgery is demonstrated by two surgeries that will be described of Coxa Vara and Genu Valgum where the 3d technology has changed the landscape of paediatric deformity correction.