3D MODEL of an anatomically inert human hand: feasibility study

Noé Lucchino; Jean-Baptiste Pialat; Christophe Marquette; Edwin Courtial; Lionel Erhard; Delphine Voulliaume; Ali Mojallal; Aram Gazarian

doi:10.1016/j.hansur.2024.101709

3D MODEL of an anatomically inert human hand: feasibility study

Hand Surg Rehabil. 2024 Apr 27:101709. doi: 10.1016/j.hansur.2024.101709. Online ahead of print.

Authors

Noé Lucchino¹, Jean-Baptiste Pialat², Christophe Marquette³, Edwin Courtial³, Lionel Erhard⁴, Delphine Voulliaume⁵, Ali Mojallal⁶, Aram Gazarian⁷

Affiliations

¹ Service de Chirurgie Plastique, Reconstructrice et Esthétique, Hôpital Saint Joseph Saint Luc, 20 Quai Claude Bernard, 69007 Lyon, France. Electronic address: noe.lucchino@gmail.com.
² Department of Radiology, Groupement Hospitalier Sud, Hospices Civils de Lyon, CREATIS Université Lyon 1, CREATIS-LRMN, 69495 Pierre-Bénite, France.
³ 3D.FAB, Université Lyon, Université Lyon1, CNRS, INSA, CPE-Lyon, ICBMS, UMR 5246, 43, Bd du 11 Novembre 1918, 69622, Villeurbanne Cedex, France, CNRS/UMR/5220-INSERM U630, Université Claude Bernard Lyon 1, 69100 Villeurbanne, France.
⁴ Institut Chirurgical de la Main et du Membre Supérieur, 17 Avenue Condorcet 69100 Villeurbanne, France.
⁵ Service de Chirurgie Plastique, Reconstructrice et Esthétique, Hôpital Saint Joseph Saint Luc, 20 Quai Claude Bernard, 69007 Lyon, France.
⁶ Department of Plastic Reconstructive and Aesthetic Surgery, University of Lyon, Université Claude Bernard Lyon 1, Hospices Civils de Lyon, Lyon, France.
⁷ Chirurgie de la Main et du Membre Supérieur, Polyclinique Orthopédique de Lyon, Lyon, France.

PMID: 38685316
DOI: 10.1016/j.hansur.2024.101709

Abstract

Objectives: Surgery for congenital malformation of the hand is complex and protocols are not available. Simulation could help optimize results. The objective of the present study was to design, produce and assess a 3D-printed anatomical support, to improve success in rare and complex surgeries of the hand.

Material and methods: We acquired MRI imaging of the right hand of a 30 year-old subject, then analyzed and split the various skin layers for segmentation. Thus we created the prototype of a healthy hand, using 3D multi-material and silicone printing devices, and drew up a printing protocol suitable for all patients. We printed a base comprising bones, muscles and tendons, with a multi-material 3D printer, then used a 3D silicone printer for skin and subcutaneous fatty cell tissues in a glove-like shape. To evaluate the characteristics of the prototype, we performed a series of dissections on the synthetic hand and on a cadaveric hand in the anatomy lab, comparing realism, ease of handling and the final result of the two supports, and evaluated their respective advantages in surgical and training contexts. A grading form was given to each surgeon to establish a global score.

Results: This evaluation highlighted the positive and negative features of the model. The model avoided intrinsic problems of cadavers, such as muscle rigidity or tissue fragility and atrophy, and enables the anatomy of a specific patient to be rigorously respected. On the other hand, vascular and nervous networks, with their potential anatomical variants, are lacking. This preliminary phase highlighted the advantages and inconveniences of the prototype, to optimize the design and printing of future models. It is an indispensable prerequisite before performing studies in eligible pediatric patients with congenital hand malformation.

Conclusion: The validation of 3D-printed anatomical model of a human hand opens a large field of applications in the area of preoperative surgical planning. The postoperative esthetic and functional benefit of such pre-intervention supports in complex surgery needs assessing.

Keywords: 3D printing; Hand surgery; MRI; Plastic surgery; Surgical planning.