The role of 3-D printed models in planning and resection of heterotopic ossification around the elbow: A case series

Abstract

BACKGROUND: Heterotopic ossification (HO) is a concern after elbow trauma and is associated with significant limitation of movement. Although complete restoration of elbow movement is seldom possible even by surgical resection, it improves functional range of movement and quality of life. Surgical excision of HO requires meticulous preoperative planning to minimize complications such as inadequate resection, and neurovascular complications. Life size models printed with three-dimensional (3D) printing technology help in understanding the complex HO mass and its relation to neurovascular structures, thereby helping in better preoperative planning. AIM: The aim is to study the usefulness of 3D-printed patient-specific models in resection of heterotrophic ossification around elbow MATERIALS AND METHODS: The 3D models are printed using computed tomography scans by FDM technology. Surgical approaches were planned based on the dimensions and extent of the HO mass in the 3D model. Resection was performed as planned and the sterilized 3D model was also used during surgery as anatomical reference. All patients had a minimum follow-up of 1 year. They were evaluated for improvement in elbow range of motion and complications. RESULTS: Six patients underwent surgical excision of HO of the elbow, with preoperative planning using 3D-printed models. A functional range of movement was achieved in all patients. There were neurovascular complications in this case series. CONCLUSION: 3D-printed models are accurate and provide a replica of the patient-specific abnormal heterotopic ossification. 3D models provide excellent anatomical reference in planning excision by providing good orientation of the mass, dimensions, extent, and relation to neurovascular structures.