TissueDB/Tissues/Bone
Bone (osseous tissue) is a rigid connective structure that forms the skeletal framework of the body. It supports muscles, protects internal organs, and enables movement through joints. Two forms of it matter to a build. Compact bone, also called dense bone or cortical bone, is the hard outer shell that a drill or saw cuts first. Spongy bone, also called trabecular bone or cancellous bone, is the lattice beneath that shell, and the medullary canal is the central cavity of a long bone that holds the marrow.
Orthopaedic drilling is the operation this page's analogues are most often built for, and it has been studied on bone directly. Medical students, intermediate residents and surgeons each drilled 20 bicortical holes in a lamb femur: novices plunged deeper than the intermediate residents and surgeons, and adding distracting noise that masked the drill sound degraded the plunges of both experienced groups, which the authors read as evidence that "the ability to use drilling sounds to guide drilling motions is part of surgical expertise".[1] A single hands-on drilling session on a synthetic bone model cut mean plunge depth from 1.50 cm to 0.50 cm, with no significant difference between an attending surgeon and a senior resident as the teacher.[2]
Three published bone analogues report what drilling them is like. A head printed in thermoplastic polylactic acid was built with the outer table, cancellous bone and inner table each given their own tactile feedback and with replaceable frontal-bone pieces; neurosurgical residents placing an external ventricular drain on it noted similarities in the tactile feedback during drilling compared with in vivo.[3] Patient-specific temporal bones were printed from a 7-year-old patient's CT scan on a consumer stereolithography printer for a raw material cost of US$10 each; mastoidectomies drilled on them by junior residents, senior residents and attending surgeons were graded blind, and the scores separated the three experience levels (P = .012).[4] Where the bone is virtual rather than physical, a femoral-neck-fracture drilling trainer rebuilds the femur's heterogeneous, hierarchical structure with triply periodic minimal surfaces and drives its haptic feedback from that model.[5]
Materials
| Material | Visual | Tactile | Simulator | Notes |
|---|---|---|---|---|
| Animal Bone | Long Bone Drilling Simulator | Listed in ETALO Basic Simulator Matrix as alternative bone analog; not demonstrated in instructional videos. | ||
| Bamboo | Long Bone Drilling Simulator | Small-diameter stick (~12 mm); Variant A bone analog for basic bicortical drilling practice. | ||
| PPR Pipe | Long Bone Drilling Simulator | Variant B: small-diameter PPR (Polypropylene Random Copolymer) plumbing pipe held in play-dough stabiliser; bone analog for basic bicortical drilling practice. | ||
| PLA | Brannan Chest Tube Simulator, Chest Tube Simulator (Bettega), Humeral Fracture Fixation Simulator, Lower Limb Deformity Correction Simulator, Micallef, Pediatric Forearm Fracture Simulator, Tibial Shaft Transverse Fracture Simulator | Rigid 3D-printed thermoplastic bone analog providing hard cortical bone and rigid bony landmarks; used for drilling, external-fixation, and skeletal-framework practice. Can be printed hollow where consumable, single-use fragments are needed.[6] | ||
| Plaster Bandage | Man-O-War Chest Tube Simulator | Plaster strips wrapped around cut plastic ribs; palpable through foam chest wall. | ||
| Pork Ribs | Multipurpose Thoracic Simulator (Carter) | Ex vivo porcine rib rack (4–5 rib segment); real bone tissue but smaller curvature than human ribs. | ||
| Chalk | Ewald Percutaneous Renal Access Trainer | Chalk sticks 10 × 1.5 × 1.5 cm embedded between polyurethane foam layers to simulate ribs 10–12. Provides fluoroscopic opacity and mechanical interference for percutaneous renal access training (VAS 8.8/10).[7] | ||
| Plastic Pipe | Orthoplastic Reconstruction Simulator | Cortex analog: 3 cm diameter pipe segments (15–20 cm), packed with sand and vegetable oil for medulla, placed with 0.5 cm fracture gap between segments for external fixator placement training. | ||
| ABS | - | - | Cranial Burr Hole and Craniotomy Simulator (Bakhshi), Injection Laryngoplasty Simulator (Lee), Thoracoscopic Diaphragmatic Hernia Repair Simulator (Barsness) | Rigid 3D-printed thermoplastic used as a stiff scaffold providing rigid anatomical landmarks (e.g., skull, rib cage, or laryngeal framework). |
| Saw-bone spine model | - | - | Lumbar Laminectomy and Dural Closure Simulator (Bakhshi) | |
| Modeling Clay | Long Bone Drilling Simulator | Play-dough listed in the ETALO Basic Simulator Matrix as an additional bone analog ("play-dough pipe"); not demonstrated in the instructional videos. In the demonstrated builds, clay or play-dough is instead the soft stabiliser holding the bamboo or PPR-pipe analog on a flat surface during drilling. | ||
| Styrene foam | Laparoscopic Inguinal Hernia Repair Simulator (Kurashima) | One reusable piece of styrene foam forms the pubic bone together with Cooper's ligament. Being firmer than the surrounding sponge, it lets the trainee find both by feel when placing tacks.[8] | ||
| Clear packing tape | Soft Tissue Lesion Simulator | Over the felt. It gives a firm surface for the incision and holds the layers together, which is what makes the model durable (Wittenberg et al. 2025). | ||
| Large sponge | Soft Tissue Lesion Simulator | The source says the sponge represents "wounded skin and tissue". The wound model has no felt, tape or gelatin: the sponge is both the surface and the depth (Wittenberg et al. 2025). | ||
| Photopolymer resin (VeroWhite) | Cleft Palate Repair Simulator (Nicholas) | The reusable skeletal base of the cleft palate trainer. The source generated it from a fine-cut CT of a pathologic specimen and 3D printed it in VeroWhite; the finished base is molded in hard plastic and is reused, and the disposable soft-tissue layers are cast in silicone onto it. Nicholas et al., J Plast Reconstr Aesthet Surg 75 (2022) 3817-3825. |
Related Structures
- Periosteum — membrane surrounding bone
- Muscle — tissues requiring protection during drilling
- Blood Vessel — structures at risk during drilling
- Joint — articulation where bones meet
References
[edit source]- ↑ Praamsma M, Carnahan H, Backstein D, Veillette CJ, Gonzalez D, Dubrowski A. Drilling sounds are used by surgeons and intermediate residents, but not novice orthopedic trainees, to guide drilling motions. Can J Surg 2008;51(6):442-6. PMID: 19057732. PMC: PMC2592586.
- ↑ Ruder JA, Turvey B, Hsu JR, Scannell BP. Effectiveness of a Low-Cost Drilling Module in Orthopaedic Surgical Simulation. J Surg Educ 2017;74(3):471-476. DOI: 10.1016/j.jsurg.2016.10.010. PMID: 27839695.
- ↑ Podkovik S, Kashyap S, Bonda S, Wiginton JG 4th, Sweiss R, Wacker MR, Miulli DE. External Ventricular Drain (EVD) Placement Using a Hands-On Training Session on a Simple Three-Dimensional (3D) Model. Cureus 2022;14(8):e28014. DOI: 10.7759/cureus.28014. PMID: 36134074. PMC: PMC9470865.
- ↑ Freiser ME, Ghodadra A, McCall AA, Shaffer AD, Magnetta M, Jabbour N. Operable, Low-Cost, High-Resolution, Patient-Specific 3D Printed Temporal Bones for Surgical Simulation and Evaluation. Ann Otol Rhinol Laryngol 2021;130(9):1044-1051. DOI: 10.1177/0003489421993733. PMID: 33554632.
- ↑ Chi Z, Li J, Wang Q, Li C, Fang D, Yang G, Xie H. High-Fidelity Haptic Rendering for Virtual Drilling on Gradient Porous Bone in Surgery Training. IEEE Trans Haptics 2025;18(4):1071-1084. DOI: 10.1109/TOH.2025.3634673. PMID: 41259175.
- ↑ Micallef J, Arutiunian A, Hiley J, Benson A, Dubrowski A. The Development of a Cost-Effective Infant Intraosseous Infusion Simulator for Neonatal Resuscitation Program Training. Cureus 2021;13(10):e18824. DOI: 10.7759/cureus.18824. PMID: 34804681.
- ↑ Ewald JM, Cheng JW, Engelhart SM, Wilkinson MC, Hajiha M, Wagner H, Baldwin DD. A realistic, durable, and low-cost training model for percutaneous renal access using ballistic gelatin. Turk J Urol 2019;45(1):31–6. DOI: 10.5152/tud.2018.43569. PMID: 30668307.
- ↑ Kurashima Y, Feldman L, Al-Sabah S, Kaneva P, Fried G, Vassiliou M (2011). "A novel low-cost simulator for laparoscopic inguinal hernia repair." Surgical Innovation 18(2):171–175. DOI: 10.1177/1553350610395949. PMID: 21307013.