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3D Printed Guides for Surgical Planning and Treatment of Pathologies within the Equine Hoof
07 August 2019 (online)
Introduction: Diagnostic imaging techniques, such as CT have enabled better understanding of the causes of foot lameness and determining the appropriate treatment options. Three-dimensional modelling and printing have been increasingly used in the medical field as an aid in treating a variety of orthopaedic conditions. We believe that 3D models and subject specific guides can increase accuracy and precision in surgery and reduce surgical time.
Materials and Methods: Eight pairs of forefeet of adult horses were used for the study. Feet were positioned at varying angles and CT volumetric scans were made. Data were exported to 3D modeling software to create custom made 3D printed guides for navicular bone fracture repair and guided navicular bursa injections and compared with conventional jig methods. Surgery time and precision of placement of 3.5 mm cortical screws and injection technique were recorded.
Results: Surgery time for conventional approach ranged from 45 minute in the first surgery to 6 minutes in the last procedure. For the 3D guide approach, surgery times ranged from 10 to 2.5 minutes. For the navicular bursa injections, 3D custom made guides allowed for accurate injection of the navicular bursa ranging from 4.30 minutes to 35 seconds after placement of the guide over the foot compared with ultrasound-guided injection which ranged from 8 to 22 minutes.
Discussion/Conclusion: The recorded surgery times are an indication; there is a steep learning curve associated with the conventional approaches and these uncommon procedures can benefit from a 3D custom made guide to decrease time and improve accuracy.