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  • Jan 31, 2017

    Doctors at Pamela Youde Nethersole Eastern Hospital in Hong Kong have used 3D printing to fabricate a metal talus implant for a motorcycle crash victim. The 3D printing procedure is the first of its kind to be carried out in Hong Kong.

    Images: Sing Pao Daily News

    You might not have heard of it, but the talus is a surprisingly important bone in your body. Making up the lower part of the ankle joint, the talus sits above the heel bone and is vital for walking, acting as the main meeting point between leg and foot. Because of the importance of the talus, Hong Kong doctors knew trouble was afoot when an unnamed 30-year-old lost his entire left talus following a motorcycle accident in April 2015. The talus reportedly shot straight out of the victim’s foot during the accident, and could not be recovered at the scene.

    The complete loss of the talus (and the way in which it happened) was so rare that there were only about 20 similar cases reported worldwide. Not only was there little precedent in terms of how to treat the injury, there was little hope that the patient would be able to walk perfectly following treatment. The most common response to such an injury would be to fuse the remaining bones of the leg and foot, drastically reducing ankle movement and making the left leg shorter than the right.

    Fortunately, there was another option available to doctors at Pamela Youde Nethersole Eastern Hospital, albeit one that had never been carried out in Hong Kong before. Using 3D printing technology, the doctors were able to create a metal replica of the patient’s missing talus, by obtaining a computerized tomography (CT) scan of the patient’s healthy right ankle and converting the scanned image into a 3D printable digital model.

    Designing and 3D printing the metal implant took around two weeks to complete. However, the patient was only able to have the landmark replica bone fitted sixteen months after his accident due to repeated inflammation of the affected foot. During this extended period of time, doctors fitted the patient’s ankle with a cement spacer, a temporary solution filled with antibiotic fluid to keep the ankle healthy. (The spacer was also made with the help of 3D printing, with the doctors creating the device from a 3D printed plastic mold.)

    Image: South China Morning Post

    Fortunately, the metal 3D printed implant worked a charm once finally fitted, with mobility restored to the leg and the patient able to bend his ankle at an angle of 15 degrees (with the aid of a walking stick). One big advantage of the 3D printed metal implant is its permanence. Other, non-printed implants generally need to be replaced every three to four years.

    Following the successful operation, doctors at Pamela Youde Nethersole Eastern Hospital plan to incorporate 3D printing into future procedures when beneficial. “Now we can produce more precise implants that are based on sizes of bones of different patients,” said Dr Chiu Shin-yeung, a consultant at the hospital’s department of orthopedics and traumatology. “We can reproduce a new bone in a patient’s limb from the scanned image on the opposite limb.”

    The doctor added that patients suffering from bone cancer could benefit greatly from 3D printing-assisted treatment, but ruled out the prospect of using the technology for patients in the emergency room. In those cases, there is not enough time to accurately create a 3D printable model.

     

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