Tibial Fracture Fixation Team Logo.jpg
These 3D printed bone models feature a semi-engraved model number, gender symbol, and two drilling direction arrows on the base of each model to assist with model identification and proper orientation of the simulator.

Caption underneath

These 3D printed models accurately simulate bone length and diameter, external contour and cross-sectional shape, bicortical anatomy, cortical hardness, cancellous bone porosity, and microstructure, and far cortex thickness for both genders at drilling sites for humeral shaft fractures.[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15] These models feature a semi-engraved model number, gender symbol, and drilling direction arrows on the base of each model to assist with model identification and proper orientation. Each model has a vise attachment to allow the user to secure the model inside a standard vise clamp to maximize safety during simulation training. When a model is placed inside a standard vise clamp, the bone model will be properly positioned to simulate a patient in the supine position. These open-source, locally reproducible, and high fidelity 3D printed bone models teach essential irrigation and debridement, powered and manual drilling, and modular external fixation skills that are transferable to the performance of other limb-saving and life-saving surgeries that require hardware stabilization and fixation.[16]

Find Local 3D Print On Demand Services[edit | edit source]

On-site access to a 3D printer is not required to reproduce these bone models. The open-source 3D files can be downloaded by any 3D printing organization anywhere. Please go to this link to follow step-by-step instructions on how to find 3D print on demand services in your region.

On-Site or Remote Access to a 3D Printer[edit | edit source]

All the 3D printed models print support-free and are designed to be made on any fused filament fabrication 3D printer that has a build volume Z height of 170 mm or more (at 100% scale) or a minimum build volume Z height of 150 mm (less than 100% scale).

1. If you have on-site access to a fused filament fabrication 3D printer with a minimum build volume Z height of 150 mm, you can load the 3D files (.STL) into the printer's slicer program, go into the advanced settings in the slicer program to input the customized print settings to create the print file (.GCODE) for your 3D printer.

2. If you don't have a 3D printer on-site but can access a remotely connected fused filament fabrication 3D printer with a minimum build volume Z height of 150 mm, you can use the following open-source remote 3D printing software programs to load the 3D files (.STL), input the customized print settings, and electronically send the print file (.GCODE) to a local, networked and supported 3D printer:

Common Problems and Solutions[edit | edit source]

When importing STL files into your slicer program, check that the Z height of each STL is properly scaled in the printer slicer application.

  • Model 1: Z height is 166.75 mm at 100% scale
  • Model 2: Z height is 166.79 mm at 100% scale

To prevent printing failures, it's recommended to use (i) fresh PLA filament just out of its packaging, or (ii) a commercially available filament dryer before printing to remove moisture that may have accumulated in the PLA filament after removal from its packaging.

Before printing, inspect the printer head (extruder). If it requires cleaning, heat up and carefully clean the printer head without touching it directly to avoid thermal injury.

Watch the first several printed layers to ensure proper adhesion of the filament to the print bed.

If the printed object does not adhere to the print bed, check that the printing temperature is around 215 degrees Celsius (or within the specific filament manufacturer's recommended temperature range) and decrease the layer height to 0.2 mm.

If you are using a glass print bed (like the print bed for the Ultimaker S5 3D Printer), you may need to use the manufacturer's recommended adhesion sheet, glue, hairspray or blue painter's tape or add a brim to help ensure the object adheres to the print bed.[17]

Cost Savings[edit | edit source]

These data-driven, gender-specific, easy to print, labor-saving, eco-friendly, hygienic, and cruelty-free bone simulation models are not made with natural rubber latex, are designed with safety features to protect users, and can be locally reproduced to offer the highest fidelity, standardized orthopedic surgical simulation training at the lowest cost to medical officers and surgeons who are not orthopedic specialists.

The costs of the 3D Printed Adult Humeral Bone Models will vary depending on the region's 3D printing organizations, and locally available brands of filament. To help local 3D printing organizations calculate their pricing for 3D printing these bone models, we have provided links to a useful blog article and an online price calculator. In Nigeria, one 750 gram roll of Ultimaker White PLA filament (Shore Hardness 83D) costs €33 Euros which is equal to about 5¢ USD per gram.[18][19]

In 2022, the 3D Printed Adult Male Humeral Bone Models #1 and #2 produced by a local 3D printing business in Nigeria at 100% scale is $11.65 and $11.32 USD (not including local taxes or shipping costs).[20] The estimated filament weight and printing times for the 3D Printed Adult Male Humeral Bone Models #1 and #2 at 100% scale are 143 grams and 138 grams and 6 hours and 15 minutes, and 6 hours and 5 minutes, respectively.

The Humeral Shaft Transverse Fracture Simulator is easy and quick to assemble and does not require any tools, specialized equipment, technical expertise, or time-consuming preparation to build, install, operate and maintain this simulator within the intended place of use. The benefits of 3D printing the Humeral Shaft Transverse Fracture Simulator (3D Printed Adult Humeral Bone Models #1 and #2) locally in Nigeria are that the purchase cost is nearly 2 times cheaper and the production time is over 82 times faster than purchasing a comparable artificial bone product that is imported from abroad, and the purchase cost is over 3 times cheaper than acquiring a human cadaveric humerus prepared by a local university anatomy lab.[21][22][23] By purchasing locally made 3D printed bone models for modular external fixation skills training, the learner also supports the local economy while saving on customs dues, processing fees, and international shipping costs that would be incurred when using artificial bone products that are not made locally.

2022 Comparison of Humeral Shaft Transverse Fracture Simulator Locally Made in Nigeria to a Commercially Available Artificial Bone Product and Human Cadaveric Bone
Humeral Shaft Transverse Fracture Simulator

(3D Printed Adult Humeral Bone Models #1 and #2)

Sawbones Humerus, Plastic Cortical Shell, Left

(SKU:1006)[22]

Human Cadaveric Humerus

(Prepared by an University Anatomy Lab in Nigeria)[23]

Bone Simulator Features and Materials 3D printed, biorenewable plastic anatomic bone models are made with a rigid plastic shell and inner cancellous material. Plastic cortical shell models are made of a rigid plastic shell with inner cancellous material.
  • Human cadaveric humeral bone specimen prepared by an anatomy lab.
  • Age of donor may not be known.
  • Requires wet storage (which incurs additional fees)
Fracture Simulation Simulates a transverse mid-shaft fracture of the humerus for modular external fixation training. Requires additional preparation by user to simulate a fracture. Requires additional preparation to simulate a fracture.
Fracture Encapsulation Encapsulates transverse fracture with cellophane. Does not encapsulate or re-attach fracture. No. This would incur additional preparation and storage fees.
Vise Attachment Contains a vise attachment to safely secure the model inside a standard vise clamp. Does not contain a vise attachment. Does not contain a vise attachment.
Bone Simulator Dimensions Humerus with an overall length of 33 cm. Humerus with an overall length of 36 cm. Varies.[1][2]
Unit Cost $22.97 USD[20] $42.00 USD $75.00 USD[23]
Production Time 12 hours 20 minutes (when Adult Male Humeral Bone Models #1 and #2 are printed consecutively). Ready to ship in 42 days or more.[22] Depends on local availability of cadaver specimens which is difficult to predict.

Noteː A product comparison was not made with the:

  • Sawbones Humerus, Solid Foam, Right, ($15.00 USD) because this model simulates the intramedullary canal but not cancellous bone, and the foam material does not simulate the hardness of cortical bone and thus, could foster anti-skills, and
  • Sawbones Humerus with Oblique Fracture, Foam Cortical ($41.50 USD) because this model's rigid foam shell cuts and drills easier than the plastic cortical shell models and thus, could foster anti-skills, and this model contains natural rubber latex which can trigger latex sensitivities and potentially life-threatening allergic reactions in healthcare workers.[24][25][26]

Acknowledgements[edit | edit source]

This work is funded by a grant from the Intuitive Foundation. Any research, findings, conclusions, or recommendations expressed in this work are those of the author(s), and not of the Intuitive Foundation.

References[edit | edit source]

  1. 1.0 1.1 Singh, Anudeep & Kumar, Anil. (2014). An Anthropometric Study of the Humerus in Adults. RESEARCH AND REVIEWS: JOURNAL OF MEDICAL AND HEALTH SCIENCES. 3. 76-81.
  2. 2.0 2.1 Mall G, Hubig M, Büttner A, Kuznik J, Penning R, Graw M. Sex determination and estimation of stature from the long bones of the arm. Forensic Sci Int. 2001 Mar 1;117(1-2):23-30. doi: 10.1016/s0379-0738(00)00445-x. PMID: 11230943.
  3. https://3dprint.nih.gov/discover/3dpx-016809
  4. https://3dprint.nih.gov/discover/3DPX-016667
  5. Society For Biomaterials 30th Annual Meeting Transactions, page 332. Femoral Cortical Wall Thickness And Hardness Evaluation. K. Calvert, L.A. Kirkpatrick, D.M. Blakemore, T.S. Johnson. Zimmer, Inc., Warsaw, IN.
  6. Ultimaker. Ultimaker PLA Technical Data Sheet [Internet]. Ultimaker Support. [cited 2021 July 29]. Available from: https://support.ultimaker.com/hc/en-us/articles/360011962720-UltimakerPLA-TDS.
  7. https://support.ultimaker.com/hc/en-us/articles/360011962720-Ultimaker-PLA-TDS
  8. Vian, Wei Dai and Denton, Nancy L., "Hardness Comparison of Polymer Specimens Produced with Different Processes" (2018). ASEE IL-IN Section Conference. 3. https://docs.lib.purdue.edu/aseeil-insectionconference/2018/tech/3.
  9. Forrest AM, Johnson AE, inventors; Pacific Research Laboratories, Inc., assignee. Artificial bones and methods of making same. United States patent 8,210,852 B2. Date issued 2012 Jul 3.
  10. National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. What is Bone? [Internet]. Bethesda (MD): The National Institutes of Health (NIH); 2018. [Cited 2021 Aug 17]. Available from: https://www.bones.nih.gov/health-info/bone/bone-health/what-is-bone.
  11. Meyers, M. A.; Chen, P.-Y. (2014). Biological Materials Science. Cambridge: Cambridge University Press. ISBN 978-1-107-01045-1.
  12. Meema HE, Meema S. Measurable roentgenologic changes in some peripheral bones in senile osteoporosis.J Am Geriat Soc 1963;11:1170-82.
  13. Bloom RA. A comparative estimation of the combined cortical thickness of various bone sites. Skeletal Radiol. 1980;5(3):167-70. doi: 10.1007/BF00347258. PMID: 7209568.
  14. Bloom RA, Laws JW. Humeral cortical thickness as an index of osteoporosis in women. Br J Radiol 1970; 43:522-7.
  15. Tingart MJ, Apreleva M, von Stechow D, Zurakowski D, Warner JJ. The cortical thickness of the proximal humeral diaphysis predicts bone mineral density of the proximal humerus. J Bone Joint Surg Br. 2003 May;85(4):611-7. doi: 10.1302/0301-620x.85b4.12843. PMID: 12793573.
  16. Debas, H. T., P. Donkor, A. Gawande, D. T. Jamison, M. E. Kruk, and C. N. Mock, editors. 2015. Essential Surgery. Disease Control Priorities, third edition, volume 1. Washington, DC: World Bank. doi:10.1596/978-1-4648 -0346-8. License: Creative Commons Attribution CC BY 3.0 IGO.
  17. https://support.ultimaker.com/hc/en-us/articles/360011987760-How-to-use-adhesion-sheets-for-the-Ultimaker-3
  18. Ultimaker. Ultimaker PLA Technical Data Sheet [Internet]. Ultimaker Support. [cited 2021 July 29]. Available from: https://support.ultimaker.com/hc/en-us/articles/360011962720-UltimakerPLA-TDS.
  19. Kuunda 3D Ltd. Personal communication. July 14, 2021.
  20. 20.0 20.1 AIGE Ltd. Personal communication. July 29, 2022.
  21. AIGE Limited. 3D printers. [Internet]. 3D Printers | AIGE Limited. [cited 2021 July 29]. Available from: https://www.aige.info/3d-printers.
  22. 22.0 22.1 22.2 https://www.sawbones.com/humerus-large-left-white-plastic-cortical-shell-w-cancellous-length-36cm-9-5mm-canal1006.html Cite error: Invalid <ref> tag; name ":2" defined multiple times with different content
  23. 23.0 23.1 23.2 Dr. Habila Umaru. Personal communication. July 20, 2022.
  24. https://www.sawbones.com/humerus-large-right-solid-foam-length-36cm-canal-diameter-9-5mm-1019-20.html
  25. https://www.sawbones.com/humerus-large-foam-cortical-shell-w-cancellous-w-oblique-mid-diaphyseal-fx-1028-22.html
  26. Recommendations For Labeling Medical Products To Inform Users That The Product Or Product Container Is Not Made with Natural Rubber Latex Guidance For Industry And Food and Drug Administration Staff [Internet]. United States Food and Drug Administration; 2014 [cited 2021 Nov 28]. Available from: https://www.fda.gov/media/85473/download.
Page data
Part of Humeral Fracture Fixation
Type Medical course
Keywords orthopedic surgery, surgical training, humeral fracture, bicortical drilling, modular external fixation, open humeral shaft fracture, 3d printing, artificial bones
SDG Sustainable Development Goals SDG03 Good health and well-being
Authors Medical Makers
Published 2022
License CC-BY-SA-4.0
Affiliations Medical Makers
Impact Number of views to this page and its redirects. Updated once a month. Views by admins and bots are not counted. Multiple views during the same session are counted as one. 87
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