Tais Casemiro Zago January 11, 2021

MEDICAL

Helping a Ballerina Dance Again through Medical Innovation

Thousands of girls and boys around the world dream of dancing ballet professionally. Ballet is an extremely specialized form of dance that requires discipline and dedication, but sometimes dedication alone is not enough.

Natalie before and after side by side
Natalie before and after side by side

As in most kinds of sports, unexpected injury or illness can lead to disability or force a sudden end to careers, leaving people to give up their dreams.

This is one of the many patient treatment stories that our Clinical Engineers have helped to succeed over the last 15 years. 

Natalie, a 13-year-old girl from the United States, who is one of many young aspiring dancers that felt connected to the art of ballet from an early age. She had the talent and determination to go through the rigorous training this dance demands and was on the path to a promising career.

Some months ago, a traumatic elbow injury put a question mark on her dream. Her instructors said that her career as a ballerina was over if the deformity couldn’t be corrected. Thankfully, Materialise has been continually working to make setbacks like Natalie’s only temporary.

3D Planning for Surgical Success

Our role as a company that invests heavily in innovation is to make sure that we create technology to enable dreams to come true.

Our osteotomies service is a great example of how new technologies can help to improve patient outcomes. In our experience of planning almost 2,500 bone deformity corrections, we see that these surgeries can be extremely challenging for orthopaedic surgeons as adequate tools are often not available.

When Natalie first consulted with Dr. Thomas Dovan from the Elite Sports Medicine + Orthopedics hospital in Tennessee, USA, she was diagnosed with what is called a valgus deformity, which angled her forearm away from her body.

13-year-old Natalie had a valgus deformity, which angled her left forearm away from her body.

13-year-old Natalie had a valgus deformity, which angled her left forearm away from her body. Photo credit: Dr. Dovan 

After the initial diagnostic X-ray, Dr. Dovan thought the issue was in her upper arm and he had her scheduled for surgery to correct the humerus bone.

During a second consultation just before the surgery, Dr. Dovan decided to send the images of the injury to Ruben O’Hara-Plotnik, one of our Clinical Engineers, so he could perform a 3D analysis of the injury.

When a request like this arrives at Materialise, the first step for our engineering team is to create 3D images from the original CT images using Materialise Mimics software. After this, a planning session is booked with the surgeon, where they discuss the next steps for surgical planning using the newly created visualization.

With the 3D images in hand, Ruben showed Dr. Dovan the extent of the deformity on the surgical side compared with the healthy side. After comparing both sides, it became clear that the deformation was not in the humerus, but rather the ulna was the bone to be corrected.

Materialise Clinical Engineer Ruben O’Hara-Plotnik shows the surgeon the  3D analyses  of the deformity,  available for visualiz
Materialise Clinical Engineer Ruben O’Hara-Plotnik shows the surgeon the  3D analyses  of the deformity,  available for visualiz

Materialise Clinical Engineer Ruben O’Hara-Plotnik shows the surgeon the  3D analyses  of the deformity,  available for visualization on SurgiCase, the 3D online planner of Materialise.  Image credit: Materialise 

 

“One of the big advantages of these planning sessions is the possibility to compare the injured side with the contralateral, healthy side. Understanding this kind of bone deformity correction can be extremely challenging for surgeons having just a plain X-ray or even CT slices as the problem is three-dimensional. A 3D analysis makes the deformity crystal clear from any possible angle and forms the basis for the treatment plan,” says Ruben O’Hara-Plotnik, Materialise Clinical Engineer.

Clinical Engineer Ruben O’Hara-Plotnik during the planning session.

Clinical Engineer Ruben O’Hara-Plotnik during the planning session. Photo credit: Materialise  

 

During the planning session, Dr. Dovan was able to decide on all steps of the surgery, including the positioning of the metal plates he was going to use to correct the bone. He also opted to order our personalized guides for use intra-operatively, which are designed to fit the unique anatomy of the patient.  

The osteotomy guides are designed to match the patient’s unique anatomy and to guide the surgeon intra-operatively. Image credit

The osteotomy guides are designed to match the patient’s unique anatomy and to guide the surgeon intra-operatively. Image credit: Materialise 

 

A Personalized Solution for Renewed Mobility

With a better understanding of the extent of the injury and a detailed plan in hand, Dr. Dovan was now ready for a surgery customized just for Natalie. During the surgery, Dr. Dovan positioned the guides onto the bone to guide the pre-drilling of the screw holes and the planned osteotomy cuts.

Cutting a bone freehand is an extremely difficult procedure that demands a lot of practice and expertise of the surgeon. Because 3D planning enables surgeons to make all important decisions beforehand, the use of the personalized guides allowed Dr. Dovan to precisely follow his pre-operative plan and achieve an accurate correction.

quote

Using Materialise allowed us to dial in the correction perfectly. This type of correction would have been nearly impossible without Materialise.
- Dr. Thomas Dovan, Elite Sports Medicine + Orthopedics hospital in Tennessee, USA

The outcome for Natalie could not have been better: the surgery restored symmetry to her upper limbs and she was able to fully recover her movements.

After surgery, Natalie’s left forearm is corrected, allowing her to go back to ballet.

After surgery, Natalie’s left forearm is corrected, allowing her to go back to ballet. Photo credit: Dr. Dovan 

 

Speaking about the collaboration, Dr. Dovan said, “Using Materialise allowed us to dial in the correction perfectly. Without arm symmetry she could not advance to be a professional ballerina. Now that her arm is straight, she is able to pursue her dream! This type of correction would have been nearly impossible without Materialise.”

Dr. Thomas Dovan from the Elite Sports Medicine

Dr. Thomas Dovan from the Elite Sports Medicine + Orthopedics hospital in Tennessee, USA. Photo credit: Dr. Dovan 

 

Now back to ballet, Natalie has been accepted into two of the top-three ballet summer intensive programs in the USA. With the path to becoming a professional ballerina back in sight, we wish Natalie the very best in her future career.

Empowering Innovation to Create Positive Impact in People’s Life

Over the last 30 years, 3D technologies have open new frontiers to push the boundaries of digital planning and design of devices.

 

Materialise Clinical Engineer Ruben O’Hara-Plotnik shows the surgeon the  3D analyses  of the deformity,  available for visualiz

3D visualization of the post-operative scan on Materialise SurgiCase shows how the injured side now aligns with the healthy side. Image credit: Materialise 

 

Materialise Medical has pioneered many of the leading medical applications in surgical planning and 3D printing, enabling researchers, engineers, and clinicians to revolutionize personalized care.

A personalized treatment can assist surgeons at different stages in the treatment of complex limb problems, allowing digital and better visualization of pathology, 3D printing of anatomical models, virtual planning of surgical procedures and the printing of personalized cutting guides. Our goal is to support surgeons to perform more predictable outcome and achieve higher patient satisfaction. If you have a complex osteotomy case, don’t compromise, personalize. We would love to help you with a first free visualization.

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Interested in personalized treatments?

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3D planning and 3D printing mean for personalization.

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