Liesbeth Kemel May 19, 2014

One of the worst ways to spend a vacation is in an emergency room. Especially after surviving a 35-foot fall, breaking all four limbs and, worst of all, shattering your face. This is exactly what happened to 27-year old Jon Fenton when he was vacationing in Barcelona and fell face first off of his four-story high hotel balcony. His initial emergency treatment was completed in Barcelona: the surgeons there stabilized him and used trauma plates to put his facial bones in the best position they could. Once stable, he returned home to Nottingham, UK. Several days after the fall he was transferred to the Queen’s Medical Center at the University of Nottingham. He was left unrecognizable so the doctors knew that they would have a lot of work to get him back the way he looked prior to the accident. According to Daren Forward, a consultant in orthopedic trauma at the Queen’s Medical Centre, University of Nottingham, “Mr. Fenton had basically broken everything – his case was pretty much up there with as bad as it gets.”

Jon post operation at the Queen’s Medical Center.
Jon post operation at the Queen’s Medical Center.

Jon recovered from the initial surgery and undertook intensive physical therapy.  The process then began for his secondary facial reconstruction as the original repair had not been successful in completely restoring his facial appearance. To plan the reconstruction of Jon's face, the maxillofacial surgeon, Dr. Dilip Srinivasan, requested further CT data.  A 3D-printed model of the shattered skull was built using the Mimics Innovation Suite.

3D printed models of Jon’s skull pre and post operation.
3D printed models of Jon’s skull pre and post operation.

The Mimics Innovation Suite is a vital tool when it comes to assessing complex facial traumas. “It allows us to get a full understanding of the extent of the injuries as a whole, not just in isolation,” said Jason Watson, consultant for maxillofacial prosthetics at the medical center. Traditional laboratory techniques with dental models and fixation based on the teeth cannot be used to accurately reposition these multiple, complex fractures. The 3D computer reconstructions allow the laboratory to look at different structures, creating multiple masks within Mimics and plan the reconstruction in a systematic way. These masks can then be converted to STL files and manipulated further to show the planned final result, and also export to the Rapid Prototyping machine. The 3D model of Jon’s actual face, which outlines the position of his bones and trauma plates that had been placed in Barcelona, provided insight into the exact extent of the injury. The model was very useful when explaining to the patient the complex process of secondary reconstruction, which also improves the process of getting “consent” before treatment. Performing the laboratory planning, carrying out the virtual surgery on the models, planning the sequence of repair, producing the surgical guides and pre-bent plates took around 16 hours.  This saved time in the operating room and gave the surgeon invaluable insight as to what he would face during the operation. Jon still has a long recovery period ahead of him; however, his facial reconstruction was an important milestone. "Six months ago everything was looking really bad but his face operation has gone so well and he looks so much better. Before he was quite disfigured," his fiancée said.

 

Disclaimer: Only 3D-printed anatomical models created with Materialise Mimics inPrint in conjunction with compatible 3D printers are cleared for diagnostic use.

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