Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Jan 18, 2022; 13(1): 1-10
Published online Jan 18, 2022. doi: 10.5312/wjo.v13.i1.1
Three-dimensional printing in paediatric orthopaedic surgery
Sven Goetstouwers, Dagmar Kempink, Bertram The, Denise Eygendaal, Bart van Oirschot, Christiaan JA van Bergen
Sven Goetstouwers, Dagmar Kempink, Denise Eygendaal, Department of Orthopaedic Surgery and Sports Medicine, Erasmus Medical Centre/Sophia Children's Hospital, Rotterdam 3015GD, South-Holland, Netherlands
Bertram The, Denise Eygendaal, Christiaan JA van Bergen, Department of Orthopaedic Surgery, Amphia Hospital, Breda 4818CK, North-Brabant, Netherlands
Bart van Oirschot, 3D Lab, Amphia Hospital, Breda 4818CK, North-Brabant, Netherlands
Author contributions: All authors contributed to the writing of the manuscript and approved the final version.
Conflict-of-interest statement: All authors have nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Christiaan JA van Bergen, MD, PhD, Surgeon, Department of Orthopaedic Surgery, Amphia Hospital, Molengracht 21, Breda 4818CK, North-Brabant, Netherlands. cvanbergen@amphia.nl
Received: March 18, 2021
Peer-review started: March 18, 2021
First decision: July 18, 2021
Revised: July 29, 2021
Accepted: December 21, 2021
Article in press: December 21, 2021
Published online: January 18, 2022

Three-dimensional (3D) printing is a rapidly evolving and promising field to improve outcomes of orthopaedic surgery. The use of patient-specific 3D-printed models is specifically interesting in paediatric orthopaedic surgery, as limb deformity corrections often require an individual 3D treatment. In this editorial, various operative applications of 3D printing in paediatric orthopaedic surgery are discussed. The technical aspects and the imaging acquisition with computed tomography and magnetic resonance imaging are outlined. Next, there is a focus on the intraoperative applications of 3D printing during paediatric orthopaedic surgical procedures. An overview of various upper and lower limb deformities in paediatrics is given, in which 3D printing is already implemented, including post-traumatic forearm corrections and proximal femoral osteotomies. The use of patient-specific instrumentation (PSI) or guiding templates during the surgical procedure shows to be promising in reducing operation time, intraoperative haemorrhage and radiation exposure. Moreover, 3D-printed models for the use of PSI or patient-specific navigation templates are promising in improving the accuracy of complex limb deformity surgery in children. Lastly, the future of 3D printing in paediatric orthopaedics extends beyond the intraoperative applications; various other medical applications include 3D casting and prosthetic limb replacement. In conclusion, 3D printing opportunities are numerous, and the fast developments are exciting, but more evidence is required to prove its superiority over conventional paediatric orthopaedic surgery.

Keywords: Three-dimensional printing, Paediatric, Orthopaedic surgery, Intraoperative, Patient-specific instrumentation, Guiding

Core Tip: Three-dimensional (3D) printing for intraoperative use in paediatric orthopaedic surgery is a relatively novel field. Research has shown that 3D anatomic models can be used for patient-specific instrumentation and patient-specific templates, that possibly allow the orthopedic surgeon to perform complex surgery more accurately. Based on the latest scientific evidence, this editorial provides an overview of the overall role of 3D printing in intraoperative applications of upper and lower limb surgery in paediatric orthopaedics.