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3-D modeling Allows Surgeons to Plan & Practice Before Surgery
She was beautiful with soft brown eyes and a gentle gaze. Found as a stray outside of Albuquerque, N. M., she had been at IHS for five months, and when Bergeron read more about her he found out why. The rescue agency noted that she had early signs of hip dysplasia and would need surgery down the road. Additionally, she needed a little extra TLC to recover from surgery to remove old, infected stitches left in after a spay surgery earlier in her life.
 
Bergeron's heart went out to her. Looking to bring a dog back into his life(when he and his wife divorced, she got"custody" of their two dogs), Bergeron decided he would deal with whatever health issues came up and adopted Leta. When he got her home, he brought her to the Arapahoe Animal Hospital where an X-ray showed she did not have hip dysplasia, but rather an angular limb deformity on her back right leg. The hospital referred Bergeron to the Colorado State University Veterinary Teaching Hospital to investigate surgical options to fix Leta's leg.
 
"Historically, one of the challenges we face when an animal has a complex limb deformity is that we take an X-ray and then have to use a 2-dimensional image to figure out how to do a surgery to correct a 3-dimensional object," said Dr. Ross Palmer, Leta's surgeon and a member of the Small Animal Orthopaedics Service at the Veterinary Teaching Hospital. "For many years, I would make paper cut-outs from X-rays and try to model and plan surgeries basically using paper doll technology. Right away, accuracy is questionable."
 
A CT scan has the ability to build a 3-dimensional image so that surgeons can get a better understanding of what's going on, but it still doesn't provide the information needed to know exactly how to fix it. It would be great to be able to "take the 3-D image out of the screen and hold it," said Dr. Palmer, and that's exactly what he was able to do with Leta. The 3-D image of Leta's bad leg was sent to a specialized laboratory where it was "printed" out as a 3-D model – an actual life-size model of the patient's bone.
 
"No one has touched this dog with a scalpel, and yet I'm holding a part of her skeleton," said Dr. Palmer. "It gives us the ability to do intricate advanced planning, try a few different approaches, and do some advanced assembly based on our modeling. If something doesn't work, no harm done. We print another model. Obviously, this type of modeling and planning isn't necessary with orthopaedic procedures where you may have a simple deformity in one plane, but for complex problems with multiple levels of deformity this technology gives us an incredible advantage.
 
"It's uncanny to go into surgery, expose the bone, and feel like, 'I've been here before.' Three-D modeling diminishes the number of surprises and that's a really good thing when you're talking about surgery."
Leta had a valgus deformity, where the lower portion of her limb angled outward, as well as twisting of the limb top to bottom, most likely the result of a birth defect. Dr. Palmer worked on Leta's 3-D bone model to devise the best surgical approach to correct her leg, then took his planning into the surgical suite. Leta had surgery on April 11 and continues to recover, but Dr. Palmer and Bergeron are pleased with the surgical results and with Leta's prognosis. Post-surgery, notes Dr. Palmer, she is now in that dangerous stage where the bone is still healing but she is feeling better, bored, and wants to move.
 
"I'm looking forward to her having a normal dog's life," said Bergeron. "We've got some work to do, and she needs some classes to work on her manners and predictability, but she is so sweet and so smart – I think we are both ready to see what life can be for her now."


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