Doctor-patient relationship is mostly build on effective communication which plays an important role in delivering proper health care. Doctors have the duty to provide appropriate and sufficient information to the patient, concerning his medical condition and the available treatment options. The breakdown between doctor-patient relationship is the cause of majority of patients' complaints and aversions. Using customized 3D printed models for each patient and having the conversation and the explanations needed, based on the palpable particularities of the patient's medical condition, helps towards a more efficient communication and a better understanding of the ailment and the treatment's outcomes, thus reducing patients' insecurities to the medical act, preventing complaints, dissatisfaction and malpractice accusations.

Introduction. Among the cases of malignant tumors, gathering 30% of them, the most frequent is the osteosarcoma. It occurs especially in children and young adults, the mean age being 14 years old. The treatment consists initially in neoadjuvant chemotherapy, followed by the surgical removal of the tumor. Due to aggressive malignant features (rapid increase in size, tendency to invade surrounding tissues, variable location), in multiple cases, the surgical treatment of osteosarcoma becomes a true challenge. Materials and methods. Nowadays, it is possible to create 3D printed models, by using CT and MRI, which are superior to the 3D graphical reconstructions. The 3D printing technique facilitates the production of these 1:1 scale printed models that faithfully embody the patient's particular features concerning the anatomic pathology. The benefits gained from using such a modern tool allow the orthopedic surgeons to establish the measurements of a precise resection and to simulate the surgical maneuvers, as part of an elaborated modern surgical planning. Results. In this article, we presented the case of a 10-year-old patient diagnosed with femoral osteosarcoma and treated with neoadjuvant chemotherapy followed by GMRS surgical approach based on a preoperative planning involving a 3D printed model. This piece was used to provide precise information regarding the tumor, to allow preoperative measurements and a surgical simulation. Conclusion. The surgical accuracy can be increased by using a personalized preoperative planning based on a 3D printed model, leading to a lower rate of long/ short-term complications, recurrences, or metastases.

The purpose of this paper is to evaluate the postoperative results in paediatric patients with osteoid osteoma. We present a retrospective study including 16 patients under 18 years old treated surgically in our institution between April 2019 and September 2020. Patient demographic data, clinical aspects and imaging studies used to establish the diagnosis, lesion location, the size of the nidus, surgical data, hospitalization periods, complications and particular conditions were noted.Sixteen patients with mean age of 11.19 years (between 5 and 17 years) were treated using surgical excision (open or minimal invasive) or radiofrequency ablation (RFA). All patients presented with night pain highly responsive to nonsteroidal anti-inflammatory drugs. Imaging studies before surgery included radiographs, CT scans and/or MRI, technetium-99 bone scans. Interval between symptoms onset and surgery varied from 3 to 18 months (mean 8.18 months). Eight patients were treated using radiofrequency ablation under fluoroscopy, 5 cases were treated using minimal invasive surgery (resection-biopsy with trocar) and 3 cases were treated by open surgical excision. We have obtained histopathologic diagnosis in all cases. One patient had a superficial wound infection and two patients presented recurrent pain. In 13 patients the pain disappeared during the first 48 hours after surgery. Mean follow-up time was 10.12 months.RFA is the treatment of choice in paediatric cases of osteoid osteoma. Vicinity of important anatomical structure are contraindications for RFA. Using ablation probes with cooled tips may result in more predictable outcomes. The tendency to use less and less invasive procedures in the surgical fields seems to lead to development of non-invasive procedure.

The evolution of modern medicine, in its continuous developing process, is highly connected with the progress achieved in the medical branch of technology. Regarding the surgical specialties, the technological progress breakthroughs may determine the appearance of new diagnosis techniques, but also shape innovative treatments, leading to superior therapeutic results. In the surgical treatment as a whole, an essential role is played by the Medical Imagistics. They either offer the much-needed visual support in order to reach an accurate diagnosis, or guide the surgeon in choosing a certain type of intervention. The importance of Imagistics is indisputable. It has also been proven so in intraoperatory guidance and monitoring the patient in post-surgery. In the evolution of medical Imagistics, after the transition to digital imaging, followed by graphic 3D reconstructions based on CT and MRI data, we find ourselves contemporary with a new turning point announcing a technological revolution: the transition from virtual 3D models to tangible 3D replica. Since the beginning, the 3D printing technology has been of great importance to the field of medical research and, once the technique gained popularity, it became a modern tool for many medical specialties, in particular for cranio-maxillofacial surgery, orthopedics, oncology, neurosurgery. The 3D printing technology managed to transgress dated barriers by facilitating the manufacturing of implants or implement new treatments in regenerative medicine. The purpose of this original paper is to present our 3D printing work protocol and general conclusions after 5 years of implementing 3D printing in pediatric orthopedics.

The 3D Printing technology is a relatively modern technology, which since its appearance in 1983, had an important and constant development. In the past decade 3D printing became more and more integrated in different areas of expertise, particularly due to an increasing level of accessibility by decreasing the prices of 3d printing machines and also due to the expansion of what used to be a niche market for 3d printing materials. Thus, 3D printing quickly became a powerful tool for areas such as medicine, automotive, airspace industry, product design, weapons industry, etc. This article approaches the role and evolution of 3D printing in medicine and how this technology is set to revolutionize medical practice by pushing it further and further, in order to reach the ideal personalized, predictive and increase safety medical treatment.