Integration of 3D technologies in preoperative planning for complex lower extremity reconstructions: a descriptive case series study

In complex lower extremity reconstruction cases, conventional methods often fall short in achieving the precision necessary for optimal outcomes. The integration of three-dimensional technologies significantly enhances pre-operative planning in these challenging scenarios, offering a promising potential for improving surgical results. The purpose of this study is to demonstrate the various ways in which our department has utilized three-dimensional technologies to effectively manage complex lower extremity reconstruction cases. Four patients who underwent complex lower extremity reconstructive surgery incorporating three-dimensional technologies at our institution were selected to demonstrate the integration of these tools in pre-surgical planning. The surgeons’ perceptions of their impact were evaluated through questionnaires. We present the case of a 17-year-old female and a 7-year-old female who underwent multiple femoral osteotomies and a tibial osteotomy, respectively, with the aid of custom 3D-printed guides; a 48-year-old female whose calcaneal allograft was shaped using 3D modeling; and a 21-year-old male who had a 3D-modeled tibial spacer created as part of the Masquelet technique. The use of three-dimensional technologies is particularly advantageous in complex cases that require precise, individualized solutions. While not all cases necessitate three-dimensional technologies, its application is most appropriate when conventional methods are insufficient, particularly in anatomically challenging situations or severe deformities. The success of these interventions depends on a multidisciplinary approach, combining the expertise of engineers and medical professionals. This case series illustrates how three-dimensional technologies may impact cases of complex lower limb reconstruction, as they enhance the understanding of patient-specific anatomy and improve surgical outcomes. Departments should consider integrating three-dimensional technologies as an adjunct in the treatment of complex lower extremity reconstruction cases.