European Journal of Plastic Surgery

, Volume 41, Issue 2, pp 137–146 | Cite as

Three-dimensional printing modeling: application in maxillofacial and hand fractures and resident training

  • Oscar Mario Jacobo
  • Virginia E. Giachero
  • Denisse K. Hartwig
  • Gustavo A. Mantrana
Original Paper



Imaging techniques in reconstructive surgery are of great assistance not only in diagnosis but also in preoperative planning; however, they are often limited to interpreting three-dimensional structures on flat surfaces. Three-dimensional (3D) printing has made it possible to overcome these limitations by allowing the creation of customized 3D anatomical models. We set out to create 3D printed models to demonstrate its application in maxillofacial and hand fractures and resident training.


Ten patients with hand and craniofacial fractures of different types were studied. Computed tomography was performed; the image files were processed digitally, and 3D models were subsequently printed. The quality and accuracy of the obtained models were rigorously evaluated, and the models were then used by plastic surgery teachers and residents in the preoperative planning.


The comparative measurements confirmed that the models are at real scale with a 1:1 ratio; the pre-cast osteosynthesis plates were perfectly matched to the patient’s anatomy intraoperatively, and the lengths of the pre-selected screws were accurate. The anesthetic surgical time was reduced by 20%. Teachers and residents were satisfied with the use of models for clinical discussions of patients and for preoperative planning and the advantages of manipulating physical models were highlighted.


We have created low-cost, good quality, reliable, and accurate 3D printed models for the preoperative planning of reconstructive surgeries of maxillofacial and hand fractures, reducing the operative times and providing a new academic teaching tool in the training of residents of plastic surgery.

Level of Evidence: Level IV, therapeutic study.


Three-dimensional printing Computer-assisted surgery Plastic surgery Maxillofacial injuries Fracture fixation Hand injuries 


Compliance with ethical standards



Conflict of interest

Jacobo Oscar, Giachero Virginia, Hartwig Denisse, and Mantrana Gustavo declare that they have no conflict of interest.

Ethical approval

All procedures in studies involving human participants were performed in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of retrospective study formal consent from a local ethics committee is not required.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2017

Authors and Affiliations

  • Oscar Mario Jacobo
    • 1
  • Virginia E. Giachero
    • 1
  • Denisse K. Hartwig
    • 1
  • Gustavo A. Mantrana
    • 1
  1. 1.Department of Plastic, Reconstructive and Aesthetic Surgery, Clinical Hospital “Dr. Manuel Quintela”, Faculty of MedicineUniversity of The Oriental Republic of Uruguay (UDELAR)MontevideoUruguay

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