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Functional Wound Recovery in Amniotic Band Syndrome Via Personalized 3D Biomodels: The Case of the Ballet Dancer
Miguel A Ceccarelli1, Regina C Schechtman1, Heron Werner2,3
1Dermatology Department, Pedro Ernesto University Hospital, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Brazil.
Objective:
To describe the clinical, imaging, and functional outcomes of a personalized magnetic resonance imaging (MRI)-based 3D-printed prosthesis for pressure redistribution and pain reduction in a ballet dancer with amniotic band syndrome (ABS).
Methods:
A 14-year-old ballet dancer with ABS and recurrent toe ulcerations, pain, and nail deformities underwent high-resolution 3T MRI for anatomic assessment and 3D reconstruction. Volumetric data were processed using MeshLab and 3ds Max to design customized prosthetic shells tailored to ballet biomechanics and pressure points. Devices were fabricated using elastic photopolymer resin. Clinical outcomes were assessed over 1 year using the Visual Analog Scale (VAS) for pain and the Foot and Ankle Ability Measure (FAAM) for function.
Results:
MRI identified complex congenital forefoot abnormalities and a rudimentary ectopic nail matrix. A conservative approach managed the suspected infection with a favorable response. The customized prosthesis enabled redistribution of pressure and improved tolerance to pointe activity. VAS pain scores improved from 10/10 to 7/10. FAAM Activities of Daily Living increased from 45% to 82.5%, and FAAM-Sports from 12.5% to 70.8%, both exceeding minimal clinically important differences. The patient reported high satisfaction (9/10), resumed ballet training, and had no lesion recurrence at 1 year.
Conclusions:
MRI-guided 3D-printed prostheses offer a feasible, low-cost, and effective strategy for managing complex biomechanical challenges in ABS, particularly in high-demand patients such as dancers. This approach supports functional recovery, pain reduction, and the prevention of recurrent soft-tissue injury.
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