These 3D printed bone models feature a semi-engraved model number, gender symbol, and a drilling direction arrow on the base of each model to assist with model identification and proper orientation.
Page data
Part of Tibial Fracture Fixation
Type Medical equipment, Device
Keywords orthopedic surgery, simulation training, open tibial fractures, bicortical drilling, modular external fixation, Schanz Screws, 3D printing, artificial bones
SDG Sustainable Development Goals SDG03 Good health and well-being
Authors Medical Makers
Published 2021
License CC-BY-SA-4.0
Affiliations Medical Makers
Impact Number of views to this page. Views by admins and bots are not counted. Multiple views during the same session are counted as one. 871
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These 3D printed models accurately simulate bone length and diameter,[1][2] external contour, cross-sectional shape,[2][3] bicortical anatomy, cortical hardness,[4][5][6] cancellous bone porosity,[7][8] and microstructure,[9] and far cortex thickness for adult, non-obese males[10] at left tibial shaft fracture pin drilling sites for modular external fixation. These models feature a semi-engraved model number, gender symbol, and drilling direction arrow 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 models teach bicortical drilling and modular external fixation skills that are transferable to the performance of other limb-saving surgeries that require hardware stabilization and fixation.

Bill of Materials[edit | edit source]

  1. White PLA Filament

In Nigeria, the 3D Printed Adult Male Tibial Bone Models #1, #2, and #3 cost $8.90, $9.35 and $9.30 USD, respectively.[11]

In Nigeria, one 750 gram roll of Ultimaker White PLA filament (Shore Hardness 83D)[4] costs €33 Euros[12] which is equal to about 5¢ USD per gram.

Tools Needed[edit | edit source]

All 3D printed models are designed to be made on any single extruder, fused deposition modeling 3D printer that has a minimum build volume Z height of 210 mm.

These include but are not limited to the following open-source, open filament 3D printers:

  1. Ultimaker S5
  2. Lulzbot TAZ Workhorse

All the 3D printed bone models are designed to:

  • print without support material, rafts or brims
  • require no cleaning, sanding, gluing, priming, painting, dipping, coating, smoothing, polishing, or any post-processing
  • not require any non-3D printed parts, and
  • be ready for use right out of the 3D printer.

Required Skills and Knowledge[edit | edit source]

STL -> G-CODE -> 3D Printer[edit | edit source]

  1. If you don't have on-site or virtual access to a 3D printer, you can email the 3D file (.STL) to a local 3D printing service with instructions to use the corresponding 3D printer settings outlined in the section below.
  2. If you have on-site access to another 3D printer, 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 settings outlined in the section below to create the print file (.GCODE) for your 3D printer.
  3. If you don't have a 3D printer on-site but can access a remote, connected 3D printer, you can use load the 3D files (.STL) into an open-source cloud client for 3D printers, input the corresponding 3D printer settings, and electronically send the print file (.GCODE) to a local, networked and supported 3D printer.

Technical Specifications and Assembly Instructions[edit | edit source]

Download STL Files[edit | edit source]

Download the 3D files (.STL) below and input the print settings for the corresponding 3D printer to create the print file (.GCODE) for that printer.

Adult Male Tibial Bone Model STL Files
Model Number Anatomic Region Simulator Build Module Skills Training Module File Name Revision Date Download File
1 Tibial Shaft Tibial Shaft Simulator Bicortical Drilling Skills Model 1 - Male.STL November 15, 2021 File:Model 1 - Male.stl
2 Proximal Fragment of Tibial Shaft Transverse Fracture Tibial Shaft Transverse Fracture Simulator Modular External Fixation for an Open Tibial Shaft Transverse Fracture Model 2 - Male.STL November 16, 2021 File:Model 2 - Male.stl
3 Distal Fragment of Tibial Shaft Transverse Fracture Tibial Shaft Transverse Fracture Simulator Modular External Fixation for an Open Tibial Shaft Transverse Fracture Model 3 - Male.STL November 16, 2021 File:Model 3 - Male.stl

STL -> GCODE Files[edit | edit source]

3D Printer Settings for Tibial Bone Properties[edit | edit source]

3D Printer Slicer Settings Tibial Bone Property
Perimeter or Wall Thickness = 6.2 mm Far Cortex Thickness
Infill = 15% Cancellous Bone Porosity
Infill Pattern = Tri-Hexagon or 3D Honeycomb Cancellous Bone Microstructure

Models #1, #2, and #3 require these 3D printer slicer settings to accurately simulate adult, non-obese, male tibial lateral diaphysis cortex thickness, and human cancellous bone porosity, and microstructure.

3D Printer Settings for Tibial Bone Model Types[edit | edit source]

3D Printer Slicer Settings Model #1 Model #2 Model #3
Top Layers Default value (usually 3-4 layers) in slicer program but not 0 0 0
Printed Object Orientation Base with the drilling direction arrow should lie flat on the print bed Base with the drilling direction arrow should lie flat on the print bed Base with the drilling direction arrow should lie flat on the print bed

Model #1 has a top and bottom base so the top layer should not be 0 to ensure the top base is covered. Since Models #2 and #3 are simulated fracture ends, then the top layer should be 0 for Models #2 and #3 to allow the tibial bone's interior anatomy to be exposed at both fracture ends.

Model #1 should be oriented with the base with the semi-engraved drilling direction arrow lying flat on the print bed. Models #2 and #3 should be oriented with the base with the semi-engraved model number, gender symbol, and drilling direction arrow lying flat on the print bed.

Create G-CODE Files for Open-Source 3D Printers[edit | edit source]

Ultimaker S5 Cura Settings[edit | edit source]

Nozzle Size 0.4 mm

Recommended Settings

  1. Filament: Generic PLA
  2. Layer Height: Fast (0.4 mm)
  3. Infill: 15%
  4. Support: none (unchecked)
  5. Adhesion: none (unchecked)

Custom Settings

  1. Wall thickness: 6.2 mm (this changes the wall line count to 21)
  2. Top layers: 4 (for Model #1); 0 (for Models #2 + #3)
  3. Infill pattern: Tri-Hexagon

Lulzbot TAZ Workhorse Cura Settings[edit | edit source]

Taz Workhorse HE | 0.5 mm

  • Category: All
  • Material: PLA
  • Profile: High Speed

Recommended

  • Print Setup -> Generate Support: no (leave unchecked)
  • Print Setup -> Build Plate Adhesion: None

Custom

  • Shell -> Wall Thickness: 6.2 mm (this changes the Wall Line Count to 12)
  • Shell -> Top Layers: 3 (for Model #1); 0 (for Models #2 + #3)
  • Infill -> Infill Density: 15%
  • Infill -> Infill Pattern: Tri-Hexagon

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 203.05 mm
  • Model 2: Z height is 202.55 mm
  • Model 3: Z height is 202.22 mm

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

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

Cost Savings[edit | edit source]

These data-driven, gender-specific, easy to print, eco-friendly, hygienic, and cruelty-free bone models can be locally made to offer the highest fidelity orthopedic surgical simulation training at the lowest cost in low to middle income countries to train medical officers and surgeons who are not orthopedic specialists. In Nigeria, the 3D Printed Adult Male Tibial Bone Models #1, #2, and #3 cost $8.90, $9.35 and $9.30 USD, respectively.[11] The estimated printing times for the 3D Printed Adult Male Tibial Bone Models #1, #2, and #3 are 6 hours and 23 minutes, 9 hours and 46 minutes, and 7 hours and 47 minutes, respectively.

The Tibial Shaft Simulator is easy and quick to assemble and does not require any tools, specialized equipment, technical expertise, or time-consuming preparation (no kitchen required) to build, install, operate and maintain this simulator within the intended place of use. The benefits of 3D printing the Tibial Shaft Simulator (3D Printed Adult Tibial Bone Model #1) locally in Nigeria[11] are that the 3D printing costs are 9 times cheaper and the production time is over 79 times faster than purchasing a comparable artificial bone cylinder product that is imported from abroad.[13] By obtaining locally made 3D printed bone models for bicortical drilling skills training, the learner also saves on customs dues, processing fees, and international shipping costs that would be incurred when using artificial bone products that are not made locally.

Comparison of Locally Made Tibial Shaft Simulator to Commercially Available Composite Cylinder
Tibial Shaft Simulator

(3D Printed Adult Tibial Bone Model #1)

Sawbones Composite Cylinder

(SKU:3403-7)[13]

Bone Simulator Features Anatomic model that simulates mid-diaphyseal tibial bone for bicortical drilling skills training in preparation for modular external fixation training of an open tibial shaft transverse fracture. Cylinder that simulates mid-diaphyseal bone for fracture fixation testing.
Bone Simulator Materials 3D printed, biorenewable plastic anatomic bone models are made with a rigid plastic shell and inner cancellous material. Hollow short fiber reinforced epoxy cylinder. Customized cellular rigid polyurethane foam filling available upon request.
Vise Attachment Contains a vise attachment to safely secure the model inside a standard vise clamp. Does not contain a vise attachment.
Bone Simulator Dimensions Variable outer diameter (including 40 mm) x 6.2 mm wall thickness x 203.05 mm length. 40 mm outer diameter x 6 mm wall thickness x 500 mm length.
Unit Cost in Nigeria $8.90 USD per model[11] $78.78 USD (original $194.00 USD pricing adjusted for model length of 203.04 mm)[13]
Production Time 6 hours and 23 minutes Ready to ship in 21 days or more[13][14][15]

The Tibial Shaft Transverse Fracture Simulator is easy and quick to assemble and does not require any tools, specialized equipment, technical expertise, or time-consuming preparation (no kitchen required) to build, install, operate and maintain this simulator within the intended place of use. The benefits of 3D printing the Tibial Shaft Transverse Fracture Simulator (3D Printed Adult Tibial Bone Models #2 and #3) locally in Nigeria[11] are the 3D printing costs are 2 - 3 times cheaper and the production time is over 29 times faster than purchasing comparable artificial bone products that are imported from abroad,[16][17] and the 3D printing costs are over 8 times cheaper than acquiring a human cadaveric tibia prepared by a local university anatomy lab.[18] By obtaining locally made 3D printed bone models for modular external fixation skills training, the learner also saves on customs dues, processing fees, and international shipping costs that would be incurred when using artificial bone products that are not made locally.

Comparison of Locally Made Tibial Shaft Transverse Fracture Simulator to Commercially Available Artificial Bone Products and Human Cadaveric Bone
Tibial Shaft Transverse Fracture Simulator

(3D Printed Adult Tibial Bone Models #2 and #3)

Sawbones Cylinder with Encapsulated Oblique Fracture

(SKU:1521-617-4)[16]

Sawbones Tibia, Plastic Cortical Shell, Left

(SKU:1104-9)[17]

Human Cadaveric Tibia

(Prepared by Local University Anatomy Lab)[18]

Bone Simulator Features and Materials 3D printed, biorenewable plastic anatomic bone models are made with a rigid plastic shell and inner cancellous material. Hollow short fiber reinforced epoxy cylinder. Customized cellular rigid polyurethane foam filling available upon request. Plastic cortical shell models are made of a rigid plastic shell with inner cancellous material.
  • Human cadaveric tibial 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 tibia for modular external fixation training. Simulates oblique mid-shaft bone of the tibia for fracture fixation testing. Requires additional preparation by user to simulate a fracture. Requires additional preparation to simulate a fracture.
Fracture Encapsulation Encapsulates transverse fracture with cellophane. Encapsulates fracture with a single layer neoprene sleeve. Does not encapsulate or re-attach fracture. Depends on specimen preparation.
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. Does not contain a vise attachment.
Bone Simulator Dimensions Tibia with an overall length of 41 cm. Not stated[16] Tibia with an overall length of 42 cm. Varies.[1]
Unit Cost in Nigeria $18.65 USD[11] $37.50 USD $53.50 USD $150.00 USD[18]
Production Time 17 hours 33 minutes (when Adult Male Tibial Bone Models #2 and #3 are printed consecutively). Ready to ship in 21 days or more.[15][16] Ready to ship in 21 days or more.[15][17] Depends on local availability of cadaver specimens which is difficult to predict.

References[edit | edit source]

  1. 1.0 1.1 Ugochukwu EG, Ugbem LP, Ijomone OM, Ebi OT. Estimation of Maximum Tibia Length from its Measured Anthropometric Parameters in a Nigerian Population. J Forensic Sci Med [serial online] 2016 [cited 2021 Jun 27];2:222-8. Available from: https://www.jfsmonline.com/text.asp?2016/2/4/222/197928.
  2. 2.0 2.1 U.S. Department of Health and Human Services  —  National Institutes of Health. Human tibia and fibula. [Internet]. Bethesda, (MD): NIH 3D Print Exchange; 2014 May 29 [cited 2021 Aug 17]. Available from: https://3dprint.nih.gov/discover/3DPX-000169.
  3. Gosman JH, Hubbell ZR, Shaw CN, Ryan TM. Development of cortical bone geometry in the human femoral and tibial diaphysis. Anat Rec (Hoboken). 2013 May;296(5):774-87. doi: 10.1002/ar.22688. Epub 2013 Mar 27. PMID: 23533061.
  4. 4.0 4.1 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.
  5. 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.
  6. 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.
  7. Meyers, M. A.; Chen, P.-Y. (2014). Biological Materials Science. Cambridge: Cambridge University Press. ISBN 978-1-107-01045-1.
  8. 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.
  9. 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.
  10. Maeda K, Mochizuki T, Kobayashi K, Tanifuji O, Someya K, Hokari S, Katsumi R, Morise Y, Koga H, Sakamoto M, Koga Y, Kawashima H. Cortical thickness of the tibial diaphysis reveals age- and sex-related characteristics between non-obese healthy young and elderly subjects depending on the tibial regions. J Exp Orthop. 2020 Oct 6;7(1):78. doi: 10.1186/s40634-020-00297-9. PMID: 33025285; PMCID: PMC7538524.
  11. 11.0 11.1 11.2 11.3 11.4 11.5 AIGE Limited. 3D printers. [Internet]. 3D Printers | AIGE Limited. [cited 2021 July 29]. Available from: https://www.aige.info/3d-printers.
  12. Kuunda 3D Ltd. Personal communication. July 14, 2021.
  13. 13.0 13.1 13.2 13.3 https://www.sawbones.com/cylinder-40mm-od-w-6mm-wall-length-500mm-4th-gen-composite3403-7.html
  14. https://www.sawbones.com/cylinder-10mm-od-w-2mm-wall-length-150mm-4th-gen-composite3403-17.html
  15. 15.0 15.1 15.2 https://www.sawbones.com/
  16. 16.0 16.1 16.2 16.3 https://www.sawbones.com/cylinder-short-oblique-fracture-w-single-neoprene-cover-1521-617-4.html
  17. 17.0 17.1 17.2 Sawbones. Tibia, Plastic Cortical Shell, Large - SKU:1104-9. [Internet]. Vashon, (WA): Sawbones; [cited 2021 Aug 26]. Available from: https://www.sawbones.com/tibia-large-left-solid-white-plastic-no-canal-1104-9.html.
  18. 18.0 18.1 18.2 Dr. Habila Umaru. Personal communication. May 13, 2021.