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3D printing solution to complex osteotomies
and deformity corrections

We have extensive experience with boney deformity correction. The most common is a bow deformity just below the knee – this eventually causes pain on the inner aspect of the knee, and arthritis. If we get to it early enough, correcting the deformity fixes the pain, and either slows or stops the onset of arthritis. Our group has undertaken over one hundred such procedures. Another common boney correction required is for unstable knee caps, the tendon transfer is undertaken by moving the boney tubercle that the tendon connects to. These corrections are relatively straight forward to undertake.

Much more complex are some malunions – a bone fracture that has healed in a bad position. Multiple deformities can be present simultaneously, making the planning of the surgery complex. Fortunately – 3D printing technology allows novel solution. A CT scan of the bone, and matching bone from the other side is undertaken. With computer planning, the require bone cuts and plate position can be safely and reliably planned and performed.

A case recently undertaken by David Mitchell is as follows. A proximal humeral fracture failed to unite in good position. Clinically – it was painful & stiff, instead of a full 180 degrees of forward flexion, only 45 degrees was available. CT scans of both shoulders were undertaken, and it was apparent the mal union was 45 degrees of extension, 30 degrees abduction, and 10 degrees of internal rotation. The location of the deformity was immediately below the joint, near a critical nerve. A 3D drilling and separate cutting guide were custom manufactured to fit her existing humerus, with the intention that with the wedge removed, a plate secured to the planned drill holes would correct the deformity.


At six weeks from surgery already the new range of movement is 110 degrees, pain reduced, and function in day to day living already better. Further clinical improvement is expected over the next six weeks, and a final result apparent at 18 months. Current XR’s show the bone and plate in excellent position, the the osteotomy uniting. Because of concomitant osteoporosis, more screws have been used, but overall, the XR looks like nothing unusual happened.