Phalanx Reconstruction for Extremity Functional Recovery

Traumatic amputation of a digital segment with bone loss leaves a patient in severe disability. The degree of disfigurement and function loss of the hand can be severe and permanent. In general, single-digit replantation is recommended only in selected circumstances. Reconstructive procedures are restricted by limited shape and have the disadvantage of severe donor site morbidity. To overcome these limitations, we have developed a tissue engineering approach to create the missing bone phalanx, combining the fabrication of patient-customized artificial phalanges. The overall shape of the scaffold is ultimately controlled by computed tomographic files, taken from the patient’s, so as to match exactly the specific anatomic shape of the missing digital segments. A stereo lithography printer is used to print a 3D model of the missing phalanx. This model is used to create a negative replica in the form of a mold. The artificial phalanx is manufactured by casting a gas-in-water foam inside the mold and using as the scaffolding material an osteoinductive mixture of gelatin and a blend of nano hydroxyhapatite particles/decellurized human bone powder.