APRIL 2022 | The Surgical Technologist | 171 I AM A SURGICAL TECHNOLOGIST. procedures of the foot and ankle and demonstrated success with only two failures reported (one nonunion and one infection).45 Custom 3D-printed sphere implants have been safely used for patients undergoing tibiotalocalcaneal arthrodesis with more patients achieving successful fusion compared with patients receiving femoral head allografts.46 Recently, Nwankwo et al47 reported a 5-year follow-up of a distal tibia 3D-printed cage used for severe bone loss secondary to trauma, which is currently the longest known follow-up Table 2. Limitations of Current Methods to Treat Large Bony Defects Allograft Autograft Vascularized Autograft Non–Three-dimensional Printed Metal Augments Bone Transport Limited size and shape Limited size and shape Limited size and shape Limited size and shape Patient tolerance of the external fixator Collapse of dead bone Limited biologic activity with increasing age and comorbidities Unable to be performed in compromised patients (eg, smokers) Pin site infection Figure 6 A, Anterior-posterior (AP) radiograph of the left leg of a 22-year-old woman who was injured in a motor vehicle collision. She sustained an open tibia and fibula fracture. Bone was lost at the scene, leaving a large bony defect. B, Custom three-dimensional (3D) printed implant designed to fill the bony defect. C, Intraoperative image showing the distal tibia fracture and bone loss. D, Three-dimensional printed anatomic spacer block to assess alignment and length and to perform intramedullary reaming. E, AP radiograph demonstrating successful implantation of the 3D-printed implant. F, Lateral radiograph demonstrating successful implantation of the 3D-printed implant. Journal of the AAOS Global Research & Reviews® ----- April 2021, Vol 5, No 4 ----- © American Academy of Orthopaedic Surgeons 7 Review Article Colleen M. Wixted, BS, et al
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