Screws and plate used to repair a hip fracture (image credit 3Dprint.com
I wish RapidMade's recent blogging silence was due to the holidays. Alas, I was sidelined by a bad fall down a steep flight of stairs. Shortly after I broke my foot, shattered my wrist, and learned I needed surgery, I remembered a conversation I had with an NIH representative at the FDA's meeting on 3D printing. He expressed frustration that, despite additive manufacturing being more widely adopted in medicine, many procedures were not benefitting from its customization. Ironically, he specifically mentioned the screws used in orthopedic surgery, saying it was frightening that patients' bones were modified to accommodate the screws and not vise versa.
I was in too much pain to think to ask my surgeon if my standard-issued screws and plate matched my bones well enough or ask how often fit is a problem, so I will have to speculate on what factors have slowed its adoption.
First, I suspect screws could quickly and easily be cut to fit. But if that is true then why would surgeons ever alter the recipient's bones instead?
I also wonder if the simple screw and plate designs make 3D printing them more expensive and time consuming than traditional manufacturing, especially if custom fittings are rarely required. Interestingly, I just read about a hip surgery where Dr. Bagaria repaired a hip fracture by taking CT scans to create a 3D print that allowed him to plan the surgery and customize his approach.
“Using the model, Dr. Bagaria was able to create a 7-hole reconstruction plate that was pre-contured. They then used the model to carry out a surgical simulation prior to taking part in the real thing. The surgeons were able to drill the screw trajectories, measure the screw lengths required, and confirm the positions of the plate, all with the help of the model” (3Dprint.com).”
Perhaps a major reason 3D printed screws aren't in great demand is that surgeons don't often have CT scans of the broken bones and are therefore less likely to know fit will be an issue until the patient is on the operating table. Honestly, fixing most broken bones is fairly straight foward - and truthfully the xrays were painful enough, I don't know if I'd have welcomed getting CT scans as well. Having said this, I was told my wrist was worse than expected, requiring more work than expected, so who knows?
I won't know my outcome until Monday when the cast comes off, but I'm guessing screw size won't be a problem. I'll just be happy to type with two hands.