Dr. Daniel Penello's became a hand surgeon after growing up with a father whose three fingers were crushed in an accident during his job as a machinist.
"It was life changing," Penello, a doctor with Alexander Orthopedic Associates, said. "It was his dominant hand and really tough for him and the family."
So when patient Robert Smith, a 40-year-old ironworker, crushed his hand in a work accident, Penello felt called to help. And in this case, that involves doing a first-of-its-kind surgery.
Smith received the first ever 3D printed finger bone, which was done with the help of Additive Orthopedics, a 3D printing company with a medical focus in New Jersey.
"I came to the realization the condition wouldn’t get any better, so it was a matter of weighing the pros and cons," Smith said. "And seeing if the risk would be worth the reward."
While the surgery was successful, it didn't come easily. Because Smith is younger and uses his hands every day in his job, there is more time for the finger to have wear and tear. The implant, "printed" on surgical grade metal, had to fit over the bone and a central peg cements it in place. The interior of the prosthetic looks "like honeycomb" so the bone can grow into place.
3D implants have been done with ankles and orthopedic hardware, but never a finger, due to the small size.
"In general, patients want state-of-the-art treatment and getting the best available," Penello said. "And right now, even though it's a different way of forming the same product, it can be custom made to them and made easily versus big plants making machine products."
Doctors went through roughly 20 to 30 designs of the finger, printing out about five versions before finding the final winner.
"I've never worked on prosthetics this small before, but now we've tackled the most challenging thing you can tackle," Penello said. "So I would be very happy to do it and I'm sure there are patients in similar situations. Hopefully, information makes it to them or, now that I've done it, maybe other surgeons might contact the same company and do it themselves."
While Penello said to his knowledge Additive Orthopedics is the only company that helps with medical 3D printed prosthetics from start to finish, as the demand begins to rise the process will become more normalized.
"I think 3D printing will be the future. It can be applied for custom implants, it's cost efficient, and it will be most of the way implants are made, even if they're standard," he said. "I picture a 3D printer sitting at a hospital and when a patient comes in with a broken wrist, someone will go to the printer and type it in; almost like Star Trek, where they type in what what they need."
