In one centre, 3D printing is wholly carried out by on-duty orthopaedic surgeons. In two of the six centres, surgeons do not take part in the routine workflow or management of the facilities. Three centres hired dedicated nonmedical personnel for 3D printing. Staffing of the facilities varied greatly. In two centres, 3D printing is run as a multispeciality collaborative “point-of-care” 3D printing service. In four of the six surveyed centres, the 3D printing facilities are operated in the orthopaedics and traumatology unit. All centres outsourced their metal 3D printing tasks to commercial production partners for custom-made implants. Other technologies employed include powder bed selective laser sintering (SLS), PolyJet (PJ) and stereolithography (SLA). Acrylonitrile butadiene styrene (ABS) and polylactic acid (PLA) are common materials for FDM printers. The most popular technology is fused filament fabrication (FFF) or fused deposition modelling (FDM). In four centres, prosumer grade printers (costing €100,000) are in use by two centres. Therefore, at the hospital level, fracture-related 3D printing is one of their major services.Īll six institutions produced most (> 51%) of their 3D models in-house. Concerning only fracture-related cases, this is between 12 and 50% of the total cases. Five of the six centres have a total hospital case load of more than 100 cases and two have an excess of 200 cases per year when counting all specialities. The main points of the interviews are summarized in the appendix table (online). For each of these aspects, the current methods of the centres were summarized in a best practice consensus. For administration, the headings were organization and funding, future developments and research. For the production pathway the headings were indications, infrastructure, image acquisition, digital workflow and production. The topic headings chosen in this article are defined by the production workflow and the administrative structure. Two phone interviews were carried out with each co-author using a Delphi method regarding distinctive aspects in their current practice and later a consensus was drawn after a second phone review. The practice of 3D printing for orthopaedic trauma in six Asiatic institutions were surveyed using a structured format through the authors’ personal connections. erheblichen logistischen und technischen Barrieren, die die schnelle Lieferung von 3D-gedruckten Modellen behindern, werden diskutiert. Die Errichtung von interdisziplinär gemeinsam genutzten 3D-Druck-Abteilungen mit einer soliden Finanz- und Managementstruktur kann die Nachhaltigkeit verbessern. Die Installation von Industriemaschinen und dedizierter Software sowie der Einsatz von geschultem Personal können die Kapazität und Zuverlässigkeit der Frakturversorgung erhöhen. Infra- und Personalstruktur variierten zwischen den Einheiten. Die häufigsten Indikationen sind Acetabulum- oder andere Gelenkfrakturen und Fehlstellungen. In 6 unfallchirurgischen Kliniken, die diesen in der Routine nutzen, wurde eine Expertenbefragung durchgeführt. Infolgedessen können nicht alle Unfallchirurgen den 3D-Druck in ihre tägliche Praxis integrieren. Aufgrund komplexer logistischer, technischer Schwierigkeiten und Ressourcenbeschränkungen ist die Nutzung des 3D-Drucks aus Sicht des Krankenhausmanagements nicht einfach. Vorhandene CT-Daten werden für eine verbesserte stereotaktile Identifizierung der morphologischen Frakturmerkmale und eine verbesserte Operationsplanung genutzt. The sometimes substantial logistic and technical barriers which impede the rapid delivery of 3D printed models are discussed.ĭer Einsatz des 3D-Drucks zur Versorgung von Frakturen wird durch klinische Evidenz gestützt. Setting up interdisciplinary jointly used 3d printing departments with sound financial and management structures may improve sustainability. The installation of industrial grade machines and dedicated software as well as the use of trained personnel can enhance the capacity and reliability of fracture treatment. Infrastructure and manpower structure varied between units. The most frequent indications are acetabular and articular fractures and malalignments. We carried out an expert panel survey on six trauma units which utilized 3D printing routinely. As a result not all trauma surgeons are able to confidently integrate 3D printing into the daily practice. Due to complex logistic, technical and resource constraints, deployment of 3D printing is not straightforward from the hospital management perspective. Existing computed tomography (CT) data are exploited for better stereotactic identification of morphological features of the fracture and enhanced surgical planning. The use of 3D printing in orthopedic trauma is supported by clinical evidence.
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