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Objective: We present the use of 3-dimensional printing models with fused deposition modeling for carpal fractures surgery, and its feasibility in the preoperative planning and academic training. Nowadays, our market provides stereolithographic printers for this purpose, but their higher costs had made them little known and difficult to access. Fused deposition modeling is a low-cost technology that creates 3-dimensional models with high quality and definition. Material and Methods: We studied two patients with carpal fractures, an hamate fracture, and a scaphoid pseudarthrosis. The initial assessment included computed tomography imaging study, and the digital file was processed into Stereo Lithography format. After this, the model was printed in polylactic acid, using an “open source” fused deposition modeling technology printer manufactured in Uruguay. The resulting models were carefully evaluated and used for academic training. Different preoperatory approaches were studied, analyzing fracture patterns, calculating and enabling a precise selection of bone graft and selection of osteosynthesis screws, according to the characteristics of each patient. Results: We achieved a real scale with a 1:1 proportion models. All measurements were concordant, and the screws had an accurate longitudinal measure. Total operative time was 20% reduced. Plastic surgery teachers and residents were satisfied using the models for preoperative clinical discussion and planning, emphasizing the advantage of manipulating real scale models compared with 3-dimensional imaging. The models allow us to analyze the fractures in complete way and not just seeing the face of the bone exposed by the surgical approach or by the x-ray intraoperative image. Conclusions: We have created models of low cost, high quality, and accuracy, for the preoperatory planning of carpal fractures, accomplishing to reduce surgical time and improving the academic learning of the plastic surgery residents.

Three-Dimensional Printing Models in the Preoperative Planning of Carpal Fractures and Academic Education