3D Printing Guides Keratoma Surgery

In a case series from the University of Florida, surgeons described using 3D-printed guides or jigs to facilitate the surgical removal of hoof wall keratomas in five horses.

Both magnetic resonance imaging (MRI) and computed tomography (CT) imaging were used to locate the keratomas in the hoof wall while the horse was under general anesthesia. They then used the images to print a 3D guide to orient a hole saw to the hoof to expose the keratoma for surgical removal under a second anesthesia event.

Following removal, the surgical sites were managed as they would following conventional approaches with hoof wall patches applied after the keratinization of granulation tissue that filled the surgical wounds.

CT imaging proved to be more precise and required fewer adjustments to the guides compared with those prepared using MRI. Surgery times were shorter than usual, ranging from 20-90 minutes. In addition, the guides allowed for more precise resection, producing smaller surgical wounds following removal. All horses returned to their previous level of work after 2-4 months.

Although the approach described required two anesthetic events compared with conventional approaches for keratoma removal that typically only use standing sedation or one anesthetic event, this more precisely targeted approach may have a slightly higher success rate and seems likely to result in faster healing and return to performance.

— Biedrzycki AH et al. VetSurg 2022;13786

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