Ricerc@Sapienza

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.