Apart from the cosmetic problem they can create, very often they leave daily functional problems and predispose to future ones, such as the development of arthritis and the destruction of the joints.

“Traditionally, these deformities are treated with a surgery which should restore the bone to its original shape. Until recently, this planning was done based on simple x-rays and measurements with a protractor and ruler. This fact had the disadvantage that a three-dimensional deformation was treated in two dimensions. There was also the added disadvantage that what was designed on paper was difficult to reproduce in the operating room,” explains Mr. Nikolaos A. Darlis MD, PhD, Director of Upper Extremity Orthopedic Surgery and Reconstructive Microsurgery at Metropolitan Hospitalformer President of the Hellenic Society of Reconstructive Microsurgery (2021).

“The Department of 3D Imaging and Printing created at the Metropolitan Hospital, brings surgeons and engineers to the same table to design complex surgeries that correct limb deformities,” he continues.

3D imaging and printing

“The development of 3D imaging and 3D printing technologies has come to provide a solution to this problem, points out Mr. Darlis, who analyzes the process and the advantages of the method.

“The only condition is a CT scan of the healthy and the deformed limb and with the use of the appropriate computer systems it is possible to have a three-dimensional image of the bones on the computer. Then, any surgical intervention can be represented on the computer and see if it brings the deformed bone closer to the healthy one. This gives us the possibility of incredible precision in the design of the correction, no longer in two, but in three dimensions.

In a second step, we can print the 3D images of the bones that exist on the computer, in their actual size, on prototypes. So the simulation of the surgery can be repeated on these prototypes to see if what is designed on the computer is possible in reality. Also, this way we can test different materials, which can be used to better stabilize the bones in their new position.

In a third step, special cutting guides can be printed, that is, personalized tools, which apply only to the specific deformed bone. These are then sterilized and used during surgery to implement what is originally designed on the computer.

This approach has only advantages:
-The surgery is planned and performed two and three times before it is performed on the patient.
-The accuracy of the correction is much higher than that of any empirical approach.

Operating room time and blood loss are kept to a minimum.
– Stabilization materials are the most appropriate and the patient’s recovery is accelerated”, emphasizes the specialist surgeon.

Department of 3D Imaging and Printing within the Metropolitan Hospital

The usual process of the approach described above involves contacting companies abroad who can undertake this pre-operative planning, so all communication is done by exchanging information via e-mail or video calls. However, this kind of communication can in no way replace the immediacy and advantages of dealing with these problems personally and closely. The approach would “take off” if such a specialized company could operate within the same hospital and in direct communication with the surgeons who have the experience of applying it.

With this in mind, the Metropolitan Hospital has once again pioneered, creating a new Department, which combines the advantages of the approach with those of the direct communication of all cooperating parties. The Department is headed by the specialized physicist Mr. Nikos Angelou, having daily contact and cooperation with the surgeons. Thus, it becomes possible to design according to the requirements of the operating room exactly as determined by the surgeon or surgical team that has undertaken it, and, moreover, any modification is required within days, instead of the weeks that the same procedure requires when done remotely.

The results are speeding up the surgery with all the advantages described above, keeping costs at a very reasonable level, given that the whole procedure is completed within the hospital, and a team whose experience becomes more valuable with each incident it deals with.

The Department of 3D Medical Imaging is a step that all major metropolitan hospitals abroad have taken to provide better solutions to difficult problems. The Metropolitan Hospital is the first private or public nursing institution in Greece to create this department. In collaboration with the new Department, the hospital’s Department of Upper Extremity and Reconstructive Microsurgery has successfully treated a large number of forearm elbow and hand deformities using this technique.