1 pointBones The main advantage of the orthopedical presurgical 3d printed models is the possibility to create an accurate model, which can be used for metal osteosynthesis premodelling - the surgeons can prepare (bend, twist, accommodate) the implants prior the operation. After a sterilisation (autoclaving, UV-light, gamma-ray etc etc), those implants can be used in the planned surgery, which will decrease the overall surgery time (in some cases with more than an hour) with all it's advantages, including a dramatic decreasing of the complication rates, the X-ray exposure for the patient and for the surgeons, the cost and the recovery rates etc etc. For this purpose, you need a smooth bone model, with clearly recognizable and realistic landmarks, realistic measurements and physical properties, close to the real bone. Traditionally, the orthopedical surgeons in my institution used polystyrene models, made by hand, now they have access to 3d printed models and they are better in any way. Here are some tips how to print that thing. 1. Method - FDM. The bone models are the easiest and the most forgiving to print. You can make them with literally every printer you can find. FDM is a strong option here and, in my opinion, the best method on choice.2. Matherial - PLA - it's cheap, it's easy to print, it's the bread and butter for the bone printing. Cool extruding temperature (195-200C) decrease the stringing and increases the details in the models.3. Layer heigh - 0,150mm. This is the best compromise between the print time, the quality and the usability of the models.3. Perimeters (shell thickness) - 4 perimeters. One perimeter means one string of 3d printed material. It's width depends on the nozzle diameter and the layer thickness. For Prusa MK3 with 0,4mm nozzle 1 perimeter is ~0,4mm. To achieve a realistic cortical bone, use 4 perimeters (1,7mm). The surgeons loves to cut stuff, including the models, in some cases I have to print several models for training purposes. 4 perimeters PLA feels like a real bone.4. Infill - 15% 3d infill (gyroid, cuboid or 3d honey comb). The gyroid is the best - it looks and feels like a spongy bone. It's important to provide a realistic tactile sensation for the surgeons, especially the trainees. They have to be able to feel the moment, when they pass the cortical bone and rush into the spongiosa.5. Color - different colors for every fracture fragment. If the model is combined with a 3D visualization, which colors corresponds with the colors of the 3d print, this will make the premodelling work much easier for the surgeons. Also, it looks professional and appealing. 6. Postprocessing - a little sanding and a touch of a acrylic varnish will make the model much better.7. Support material - every slicer software can generate support, based on the angle between the building platform and the Z axis of the model. You can control this in details with support blockers and support enforcers, which for the bones is not necessary, but it's crucial for the vessels and the heart.Conclusions - the bone models are easy to make, they look marvelous and can really change the outcome of every orthopedical surgery.
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