The 3d printed prosthesis
Policlinico Gemelli, 3D printed titanium wrist saves the right hand of a new mother
Exceptional intervention carried out at Twins from Professor Giulio Maccauro’s team, director of the UOC of Orthopedics. Saved the right hand of one woman suffering from a rare tumor of the wristthanks to the installation of a custom built prosthesis with a 3D printer by an Italian company, with indications from the orthopedic surgeons of the Gemelli Polyclinic. The young woman, who has recently become a mother, is fine and moves all the fingers on her hand.
It is the first surgery of its kind in the world and represents an excellent example of personalized surgery. She is a 39-year-old patient and has already undergone several orthopedic operations to treat a rare tumor that had completely destroyed her right wrist joint. The woman has regained the use of her right hand and averted the danger of amputation thanks to a complex surgery that also represents an absolute ‘first’ worldwide.
The patient underwent resection and wrist reconstruction with radio-metacarpal stabilization, thanks to the positioning of a prosthesis produced ‘custom-made’ for her with a 3D printer
An Italian company prints the prosthesis to measure
The operation was carried out by a highly specialized team directed by Professor Giulio Maccauro, director of the UOC of Orthopedics of the Agostino Gemelli IRCCS University Hospital Foundation and Full Professor of Orthopedics at the Catholic University, Rome campus. Together with him, also Professor Antonio Ziranu, head of the UOSD of Traumatology of the Fatebenefratelli Isola Tiberina – Gemelli Isola Hospital and orthopedics researcher at the Catholic University, Dr. Elisabetta Pataia, ortho-plastic surgeon (plastic surgeon ‘dedicated’ to orthopedics) and the doctoral student Camillo Fulchignoni hand surgeon both working at the Gemelli Polyclinic. They are the ‘pioneers’ of a procedure which inaugurates a new vein of personalized medicine and opens up new and interesting perspectives in orthopedic surgery. “The use of a customized 3D prosthesis – explains Professor Maccauro – allowed us to adapt the intervention to the specific needs of the patient, guaranteeing accurate anatomical reproduction and a high degree of functionality. Wrist reconstruction with radiometacarpal stabilization represents a significant advance in the restoration of motor skills and in the patient’s quality of life.” And it is an intervention that has a particular added value for a woman who has just become a mother of a little girl; the surgeons waited for the breastfeeding period to end to intervene. The patient is affected by giant cell tumor, a rare tumor (and localization on her wrist is a rarity in the rarity) locally aggressive and relapsed several times, until completely compromising the joint. It was necessary, to save her hand, to replace her wrist with a prosthesis. But there are no ‘industrial’ (ie ready-made) prostheses for this part of the body (as happens instead for the hip or knee).
The prosthesis is in chronocobalt and titanium
“For this – adds Professor Maccauro – we contacted an Italian company, Adler-Ortho, specialized in the design and production of joint prostheses which, starting from the patient’s CT scan and following our instructions, created a prototype on the computer, printed 3D in plastic; we examined it, asked to make some modifications and at that point the final prosthesis was ‘printed’ in chronocobalt and titanium. For the operation it was necessary to carry out a double access – continues Professor Maccauro – from the dorsal part and from the volar (lower) part of the wrist, to free and secure the vessels, nerves and flexor and extensor tendons of the hand. We then performed a proximal bone resection of the forearm and a distal resection at the base of the metacarpals, which are the bones on which the fingers articulate. Finally we positioned this prosthesis, which allows us to keep the movement of the fingers”. The patient is fine, she has already returned home and is continuing her hand rehabilitation sessions. With her story, she helped write a new page in the history of orthopedic surgery But, as a mother, perhaps it matters more to her to be able to continue to caress and hold her daughter in her arms, with that hand that she had now given up for lost.
Subscribe to the newsletter