A Novel Invention of a 3D Printed Mould for Calcaneum Replacement Post Total Calcanectomy for a Recurrent Aggressive...

Advances in image processing have led to the clinical use of 3D printing technology, providing surgeons with realistic physical models of anatomy that enable them to recreate accurate bone structures. 3D-printed molds can play a central role in surgical replacements, offering both efficiency and cost-effectiveness. This case report describes the innovative creation of an anatomical calcaneum using a 3D printer. A patient presented with a recurrent aggressive stage of calcaneal giant cell tumor, which necessitated a complete resection, leaving a large void that required reconstruction. This paper outlines the 3D printing methodology used from pre-operative printing of the prototype, through the surgical procedure, to post-operative care. 3D images of the calcaneum were extracted from a CT scan and edited using 3D modelling software to print a hollow-shelled calcaneum. The printed prototype was created in two halves and sent for gas sterilization. After resecting the diseased calcaneum, the mold was filled with bone cement and clasped together with a proline mesh in between, for soft tissue attachment. Once the cement set, the shell was removed, and the shaped bone cement calcaneum was implanted into the patient with screws. The surrounding soft tissues and Achilles tendon were sutured to the mesh. Post-operatively, the patient was kept in a plaster dorsal slab for six weeks to allow for soft tissue incorporation. Six weeks after surgery, the patient began weight-bearing activities with an aesthetically shaped foot. This method for bone reconstruction is efficient, economical, and reproducible.