Detection properties of indium-111 and IRDye800CW for intraoperative molecular imaging use across tissue phantom models.

Significance: Intraoperative molecular imaging (IMI) enables the detection and visualization of cancer tissue using targeted radioactive or fluorescent tracers. While IMI research has rapidly expanded, including the recent Food and Drug Administration approval of a targeted fluorophore, the limits of detection have not been well-defined. Aim: The ability of widely available handheld intraoperative tools (Neoprobe and SPY-PHI) to measure gamma decay and fluorescence intensity from IMI tracers was assessed while varying characteristics of both the signal source and the intervening tissue or gelatin phantoms. Approach: Gamma decay signal and fluorescence from tracer-bearing tumors (TBTs) and modifiable tumor-like inclusions (TLIs) were measured through increasing thicknesses of porcine tissue and gelatin in custom 3D-printed molds. TBTs buried beneath porcine tissue were used to simulate IMI-guided tumor resection. Results: Gamma decay from TBTs and TLIs was detected through significantly thicker tissue and gelatin than fluorescence, with at least 5% of the maximum signal observed through up to 5 and 0.5 cm, respectively, depending on the overlying tissue type or gelatin. Conclusions: We developed novel systems that can be fine-tuned to simulate variable tumor characteristics and tissue environments. These were used to evaluate the detection of fluorescent and gamma signals from IMI tracers and simulate IMI surgery.

Exploratory investigation of virtual lesions in gastrointestinal endoscopy using a novel phase-shift method for three-dimensional shape measurement.

Accurate measurement of the size of lesions or distances between any two points during endoscopic examination of the gastrointestinal tract is difficult owing to the fisheye lens used in endoscopy. To overcome this issue, we developed a phase-shift method to measure three-dimensional (3D) data on a curved surface, which we present herein. Our system allows the creation of 3D shapes on a curved surface by the phase-shift method using a stripe pattern projected from a small projecting device to an object. For evaluation, 88 measurement points were inserted in porcine stomach tissue, attached to a half-pipe jig, with an inner radius of 21 mm. The accuracy and precision of the measurement data for our shape measurement system were compared with the data obtained using an Olympus STM6 measurement microscope. The accuracy of the path length of a simulated protruded lesion was evaluated using a plaster model of the curved stomach and graph paper. The difference in height measures between the measurement microscope and measurement system data was 0.24 mm for the 88 measurement points on the curved surface of the porcine stomach. The error in the path length measurement for a lesion on an underlying curved surface was <1% for a 10-mm lesion. The software was developed for the automated calculation of the major and minor diameters of each lesion. The accuracy of our measurement system could improve the accuracy of determining the size of lesions, whether protruded or depressed, regardless of the curvature of the underlying surface.

Cryo-Electron Microscopy in the Study of Antiviral Innate Immunity.

Cryo-electron microscopy is a powerful methodology in structural biology and has been broadly used in high-resolution structure determination for challenging samples, which are not readily available for traditional techniques. In particular, the strength of super macro-complexes and the lack of a need for crystals for cryo-EM make this technique feasible for the structural study of complexes involved in antiviral innate immunity. This chapter presents detailed information and experimental procedures of Cryo-EM for determining the structures of the complexes using STING as an example. The procedures included a sample quality check, high-resolution data acquisition, and image processing for Cryo-EM 3D structure determination.

Characterization and function of particulate organic matter: Evidence from lakes undergoing ecological restoration.

Particulate organic matter (POM) plays a crucial role in the organic composition of lakes; however, its characteristics remain poorly understood. This study aimed to characterize the structure and composition of POM in Lake Baiyangdian using many kinds of techniques and investigate the effects of different extracted forms of POM on water quality. The suspended particulate matter in the lake had complex compositions, with its components primarily derived from aquatic plants and their detritus. The organic matter content of the suspended particulate matter was relatively high (organic carbon content 27.29-145.94 g/kg) for the sum of three extractable states (water-extracted organic matter [WEOM], humic acid, and fulvic acid) and one stable bound state (humin). Spatial distribution analysis revealed that the POM content in the water increased from west to east, which was consistent with the water flow pattern influenced by the Baiyangdian water diversion project. Fluorescence spectroscopy analysis of the WEOM showed three prominent peaks with excitation/emission wavelengths similar to those of dissolved organic matter peaks. These peaks were potentially initial products of POM conversion into dissolved organic matter. Furthermore, the intensity of the WEOM fluorescence peak (total fluorescence peak intensity) was negatively correlated with the inorganic nitrogen concentration in water (p < 0.01), while the intensity of the HA fluorescence peak showed a positive correlation with the inorganic nitrogen concentration (p < 0.01). This suggested that exogenous organic matter inputs led to the diffusion of alkaline dissolved nitrogen from sediment into water, while degradation processes of aquatic plant debris contributed to the decrease in inorganic nitrogen concentrations in the water column. These findings enhance our understanding of POM characteristics in shallow lakes and the role of POM in shallow lake ecosystems.

Trendelenburg gait after total hip arthroplasty due to reduced muscle contraction of the hip abductors and extensors.

Background: Despite experiencing pain relief and improved activities of daily living after total hip arthroplasty (THA) for osteoarthritis of the hip, a Trendelenburg gait may be observed in some patients. The concentric and eccentric contraction patterns of hip muscles in a Trendelenburg gait are not well understood. Methods: This study included 89 patients (28 males and 61 females, mean age 66.5 ± 8.4 years, mean postoperative period 1.3 ± 0.4 years) after unilateral THA without functional impairment on the contralateral side. Gait analysis utilized a three-dimensional motion capture system to assess pelvis and hip angles, hip moment, and hip power. A Trendelenburg gait was defined as positive when nonoperative pelvic descent occurred at 30 % of the gait cycle, equivalent to mid-stance. Patients were classified into Trendelenburg gait-positive and -negative groups for statistical analysis. Unpaired t-test and chi-square test were used to compare the two groups. Multiple regression analysis was conducted to identify factors associated with the presence of a Trendelenburg gait. Results: A Trendelenburg gait was observed in 24 patients (27 %). Multiple regression analysis indicated that abduction (p < 0.01) and extension (p = 0.03) of hip joint power were significant determining of a Trendelenburg gait. Patients with a Trendelenburg gait exhibited reduced eccentric contraction of the hip abductor muscles and decreased concentric contraction of hip extensor muscles during early to mid-stance of their gait. Conclusion: Centrifugal contraction of hip abductor muscles and diminished eccentric contractility of hip extensor muscles appear crucial for hip stabilization mechanisms during gait after THA.

Electrochemical Detection of Nucleic Acids Using Three-Dimensional Graphene Screen-Printed Electrodes.

Electrochemical approaches, along with miniaturization of electrodes, are increasingly being employed to detect and quantify nucleic acid biomarkers. Miniaturization of the electrodes is achieved through the use of screen-printed electrodes (SPEs), which consist of one to a few dozen sets of electrodes, or by utilizing printed circuit boards. Electrode materials used in SPEs include glassy carbon (Chiang H-C, Wang Y, Zhang Q, Levon K, Biosensors (Basel) 9:2-11, 2019), platinum, carbon, and graphene (Cheng FF, He TT, Miao HT, Shi JJ, Jiang LP, Zhu JJ, ACS Appl Mater Interfaces 7:2979-2985, 2015). There are numerous modifications to the electrode surfaces as well (Cheng FF, He TT, Miao HT, Shi JJ, Jiang LP, Zhu JJ, ACS Appl Mater Interfaces 7:2979-2985, 2015). These approaches offer distinct advantages, primarily due to their demonstrated superior limit of detection without amplification. Using the SPEs and potentiostats, we can detect cells, proteins, DNA, and RNA concentrations in the nanomolar (nM) to attomolar (aM) range. The focus of this chapter is to describe the basic approach adopted for the use of SPEs for nucleic acid measurement.

Reconstruction of 3D Chromosome Structure from Single-Cell Hi-C Data via Recurrence Plots.

We describe an approach for reconstructing three-dimensional (3D) structures from single-cell Hi-C data. This approach has been inspired by a method of recurrence plots and visualization tools for nonlinear time series data. Some examples are also presented.

Comparing the Diagnostic Efficacy of 3D Ultrasound and MRI in the Classification of Müllerian Anomalies.

BACKGROUND: Müllerian anomalies significantly impact female reproductive health. This study aims to compare the diagnostic efficacy of three-dimensional ultrasound (3D-US) and magnetic resonance imaging (MRI) in detecting and classifying these anomalies. METHODS: A retrospective analysis of 150 patients with Müllerian anomalies was conducted at Saveetha Medical College and Hospital from March 2018 to March 2024. MRI and 3D-US examinations were performed and analyzed independently by two radiologists. Anomalies were classified according to European Society of Human Reproduction and Embryology (ESHRE)/European Society for Gynaecological Endoscopy (ESGE) and American Society for Reproductive Medicine (ASRM) guidelines. RESULTS: The septate uterus was the most prevalent anomaly, observed in 53 patients (35.3%). MRI demonstrated superior diagnostic accuracy (AUC 0.92) compared to 3D-US (AUC 0.88). Significant associations were found between presenting symptoms and specific anomaly types (p < 0.05). Inter-rater reliability between the two radiologists, with respect to classification of anomalies, was high (Cohen's kappa 0.85). DISCUSSION: MRI's superior soft-tissue contrast and multiplanar capabilities make it the gold standard for evaluating complex uterine malformations. 3D-US offers valuable real-time imaging and is particularly effective in assessing septum characteristics. The combined use of MRI and 3D-US enhances diagnostic precision and facilitates tailored management strategies. CONCLUSION: Integrating MRI and 3D-US in clinical practice improves diagnostic accuracy and treatment planning for Müllerian anomalies, ultimately enhancing patient outcomes.

Impact of 3D-Printed Anatomical Models on Doctor-Patient Communication in Orthopedic Consultations: A Randomized Clinical Trial.

Effective communication between doctors and patients is essential for treatment adherence and better clinical outcomes. Although 3D printing has advanced in medicine, its impact on doctor-patient communication still requires further investigation. This randomized clinical trial evaluated the effectiveness of 3D anatomical models as a tool to facilitate communication in orthopedic consultations. This randomized clinical trial was conducted between May 2024 and September 2024, with 46 patients randomized into two groups: 21 patients received medical explanations with the aid of 3D models, and 25 without. Patients' knowledge was assessed before and after the consultation, and the quality of communication was measured using the Communication Assessment Tool (CAT). In the group using 3D models, 76.19% of patients reported improved knowledge of their conditions, while in the group without models, the increase was 52.00%. Additionally, 14 out of 15 CAT parameters showed statistically significant differences between the groups, with p-values ranging from 0.001 to 0.021. The use of 3D models significantly improved patients' understanding and facilitated communication with doctors, proving to be an effective tool for explaining complex medical conditions.

Bioengineering breakthroughs: The impact of stem cell models on advanced therapy medicinal product development.

The burgeoning field of bioengineering has witnessed significant strides due to the advent of stem cell models, particularly in their application in advanced therapy medicinal products (ATMPs). In this review, we examine the multifaceted impact of these developments, emphasizing the potential of stem cell models to enhance the sophistication of ATMPs and to offer alternatives to animal testing. Stem cell-derived tissues are particularly promising because they can reshape the preclinical landscape by providing more physiologically relevant and ethically sound platforms for drug screening and disease modelling. We also discuss the critical challenges of reproducibility and accuracy in measurements to ensure the integrity and utility of stem cell models in research and application. Moreover, this review highlights the imperative of stem cell models to align with regulatory standards, ensuring using stem cells in ATMPs translates into safe and effective clinical therapies. With regulatory approval serving as a gateway to clinical adoption, the collaborative efforts between scientists and regulators are vital for the progression of stem cell applications from bench to bedside. We advocate for a balanced approach that nurtures innovation within the framework of rigorous validation and regulatory compliance, ensuring that stem cell-base solutions are maximized to promote public trust and patient health in ATMPs.

Robotic Pedicle Screw Placement with 3D MRI Registration: Moving Towards Radiation Free Robotic Spine Surgery.

BACKGROUND CONTEXT: Preoperative imaging for lumbar spine surgery often includes magnetic resonance imaging (MRI) for soft tissues and computer tomography (CT) for bony detail. While CT scans expose patients to ionizing radiation, whereas MRI scans do not. Emerging MRI techniques allow CT-like three-dimensional (3D) visualization of bony structures, potentially removing the need for ionizing radiation from CT scans. PURPOSE: This study aims to explore the accuracy of robot-assisted lumbar pedicle screw placement based on preoperative CT-like 3D MRI as the data source for robotic registration. STUDY DESIGN: Human cadaveric study. METHODS: CT-like 3D MRI scans of the lumbar spine were acquired in ten human cadavers. A robotic navigation platform was used to plan and navigate pedicle screw placement based on the CT-like 3D MRI. Postoperative CT scans assessed the accuracy of screw positioning compared to preoperative planning based on the Gertzbein-Robbins scale (GRS) and by direct measurement (mm). RESULTS: A total of 100 lumbar pedicle screws were robotically placed in ten cadavers (L1 through L5 bilaterally) based on CT-like 3D MRI. On postoperative CT evaluation, 99.0% of the positioned screws achieved an acceptable grade on the GRS (Grade A: n = 89 or Grade B: n = 10), with 89.0% classified as Grade A and 10.0% as Grade B. Meaning that 89.0% of screws were fully contained within the pedicle (GRS A), and 10% had a minor cortical breach <2mm (GRS B). The median deviation from the planned trajectory was 0.2 mm (axial IQR: 0.1 to 0.5 mm; sagittal: IQR: 0.1 to 0.4 mm), in both axial and sagittal planes. CONCLUSION: This study showed that image registration of CT-like 3D MRI for robotic-assisted spine surgery is technically feasible and that accurate pedicle screw placement can be achieved without preoperative CT. Each CT-like 3D MRI was successfully registered for robotic navigation. CLINICAL SIGNIFICANCE: The results suggest that CT-like 3D MRI has the potential to be a radiation-free alternative for preoperative planning and navigation in lumbar spine instrumentation procedures.

Key point trajectory prediction method of human stochastic posture falls.

The human body will show very complex and diversified posture changes in the process of falling, including body posture, limb position, angle and movement trajectory, etc. The coordinates of the key points of the model are mapped to the three-dimensional space to form a three-dimensional model and obtain the three-dimensional coordinates of the key points; The construction decomposition method is used to calculate the rotation matrix of each key point, and the rotation matrix is solved to obtain the angular displacement data of the key points on different degrees of freedom. The method of curve fitting combined with the weight distribution kernel function based on self-organizing mapping theory is used to obtain the motion trajectory prediction equation of the human body falling in different degrees of freedom at random positions in three-dimensional space, determine the key point trajectory of human random fall behaviour. The experimental results show that the mapped 3D model is consistent with the real human body structure. This method can accurately determine whether the human body falls or squats randomly, and the prediction results of the key points of the human fall are consistent with the actions of the human body after the fall.

Inhibition of return in a 3D scene depends on the direction of depth switch between cue and target.

Inhibition of return (IOR) is a phenomenon that reflects slower target detection when the target appears at a previously cued rather than uncued location. In the present study, we investigated the extent to which IOR occurs in three-dimensional (3D) scenes comprising pictorial depth information. Peripheral cues and targets appeared on top of 3D rectangular boxes placed on the surface of a textured ground plane in virtual space. When the target appeared at a farther location than the cue, the magnitude of the IOR effect in the 3D condition remained similar to the values found in the two-dimensional (2D) control condition (IOR was depth-blind). When the target appeared at a nearer location than the cue, the magnitude of the IOR effect was significantly attenuated (IOR was depth-specific). The present findings address inconsistencies in the literature on the effect of depth on IOR and support the notion that visuospatial attention exhibits a near-space advantage even in 3D scenes consisting entirely of pictorial depth information.

Strap-on Buoyant Device to Enhance Gastrointestinal Tract Retention of Felodipine Osmotic Pump Tablets.

Osmotic pump systems require prolonged retention time in the stomach to provide enhanced bioavailability and regulated release, which is quite challenging. This study used a three-dimensional printing (3DP) technique combined with a gastro-retentive floating device (GRFD) to extend the retention of the osmotic pump in the stomach and enhance its bioavailability. The strap-on buoyant device was fabricated by stereolithography 3DP and incorporated a felodipine osmotic pump tablet used in clinical practice, which enabled it to float in the stomach or dissolution media without any floating lag time. The components of the device were affixed using a snap-fix mechanism. GRFD dissolution study revealed a notable in vitro floating capability, lasting over 24 h, with a release profile similarity factor f2 = 65.28 compared to the naked tablet dissolution profile. The pharmacokinetics of felodipine osmotic pump in beagles showed a Cmax of 1.893 ng/mL, which increased to 4.511 ng/mL with GRFD. The delivery of an osmotic pump with GRFD enhanced the AUC0-∞ of felodipine from 10.20 ng/mL·h to 26.54 ng/mL·h. In conclusion, the strap-on buoyant device has been successfully designed to enhance gastrointestinal tract retention of felodipine osmotic pumps and bioavailability in beagles.

Comprehensive Dynamic 3-Dimensional Analysis of the Tricuspid Valve in Functional Tricuspid Regurgitation: Implications for Prophylactic Tricuspid Valve Intervention.

OBJECTIVES: To track and measure changes in the tricuspid annulus (TA) using 3-dimensional (3D) echocardiography during a complete cardiac cycle in patients with functional tricuspid regurgitation (TR) compared to patients without TR, and to compare tricuspid annular plane systolic excursion (TAPSE) derived from 2-dimensional (2D) and 3D coordinates as a measure of right ventricular (RV) function to the standard method of 2D fractional area change (FAC). DESIGN: Intraoperative 3D echocardiography data were collected prospectively, followed by postprocessing software analysis to track and reconstruct changes throughout the cardiac cycle. SETTING: Data were collected from 108 patients undergoing left-sided heart surgery at 2 large academic centers-Beth Israel Deaconess Medical Center in Boston, MA and Rhode Island Hospital, Providence, RI-between November 2018 and April 2020. PARTICIPANTS: The final dataset (n = 92) included 2 groups: the no significant functional TR (NTR) group (n = 74), defined as ≤ mild TR and TA <35 mm, and the significant functional TR (FTR) group (n = 18), defined as ≥ moderate TR. INTERVENTIONS: 3D TEE datasets were analyzed, and the motion of TA coordinates was tracked during complete cardiac cycle in 2D and 3D planes using postprocessing and software analysis. Computational modeling of TA motion was performed using computer-aided design. In further analysis, reconstructed and 3D printed models of TV were developed for the 2 groups. MEASUREMENTS AND MAIN RESULTS: `Patients in FTR group had larger TA size during the cardiac cycle, with less overall excursion and reduced annular dynamism. The 3D motion of TA for lateral, anterolateral, and posterolateral coordinates was lower in the FTR group compared to the NTR group [18 ± 6.8 vs 13.6 ± 8.5( p = 0.02); 15.2 ± 5.5 vs 11.3 ± 6.0 (p = 0.009); and 17.6 ± 6.6 vs 12.3 ± 5.2 (p = 0.002), respectively]. TAPSE derived from 3D planes was more accurate for RV function assessment when comapred with 2D FAC (area under the curve [AUC], 0.704; p = 0.011) than 2D TAPSE (AUC, 0.625; p = 0.129). Finally, in the FTR group, the anteroseptal-posterolateral diameter was consistently larger during all phases of the cardiac cycle compared to the conventionally measured septolateral diameter. CONCLUSIONS: 3D echocardiographic assessment of TA helps better understand its geometry and dynamism in functional TR and is more accurate than 2D measurements for RV function assessment.

3D-printed tooth for caries excavation.

BACKGROUND: To date, no suitable model tooth has been available for all standard restorative and prosthodontic procedures. To fill this gap, a realistic multilayer tooth with enamel, dentin, integrated caries, pulp, and electrometric and X-ray imaging abilities was developed. The aim of this study was to test the printed tooth while focusing on caries excavation and pulp capping. METHODS: Based on micro-CT data, a tooth was designed and produced via 3D printing. A total of 396 teeth were tested and evaluated by 66 fourth- and fifth-year students experienced in caries excavation at standard typodonts, extracted teeth and patients. They excavated the caries and capped the pulp on six teeth and rated them in a questionnaire. RESULTS: Compared with natural teeth, the printed teeth were generally rated positively and significantly better in all criteria than typodonts used previously (p < .001). They were rated as a suitable training option (Ø 2.3 ± 0.9) with fair examination conditions (Ø 2.1 ± 0.8) and easy to use (Ø 2.0 ± 0.8). Subjective learning success was also significantly greater (Ø 2.3 ± 0.9) than that of standard typodonts (Ø 3.2 ± 1.1) (p < .001). In general, the students desired more exercises with 3D-printed teeth for their studies (Ø 1.8 ± 0.8). CONCLUSIONS: Multilayered 3D-printed teeth were successfully tested and can improve and extend the teaching methods used for caries excavation and pulp capping. Its other abilities will be tested in subsequent studies. YEAR OF THE STUDY: 2023.

Pyeloplasty for the treatment of ectopic renal hydronephrosis in adults: a case series of six patients.

Background: Ectopic renal hydronephrosis is a relatively rare condition, with literature primarily consisting of scattered case studies. The ectopic kidney poses technical challenges to surgeons due to its structural and anatomical abnormalities. This study aims to share our initial experiences with minimally invasive pyeloplasty as a management approach for ectopic renal hydronephrosis in adult patients. Case Description: Between August 2018 and January 2023, six patients underwent minimally invasive pyeloplasty for ectopic kidneys. The patient cohort consisted of four individuals with pelvic kidneys, one with an iliac kidney, and one with an abdominal kidney. Among these, three cases were left-sided, two were right-sided, and one was isolated. The median patient age was 27 (range, 18-45) years. Four patients underwent robot-assisted laparoscopic pyeloplasty, while two underwent laparoscopic pyeloplasty. The median operative time was 134 (range, 63-240) minutes. After a median follow-up duration of 28.5 (range, 6-59) months, two patients required nephrectomy, with vesicoureteral reflux (VUR) and malrotation potentially contributing to surgical failure in these cases. The remaining four patients showed either stable or improved hydronephrosis and renal function. The overall operative success rate was 66.7%. Conclusions: The rarity and anatomical variations of ectopic kidneys hinder the standardization of surgical approaches. The integration of three-dimensional (3D) virtual reconstruction and tailored surgical techniques contributes to enhanced outcomes in ectopic renal hydronephrosis cases. Furthermore, continued research and refinement of surgical approaches are needed.

Regulating the Spin-State of Cobalt in Three-Dimensional Covalent Organic Frameworks for High-Performance Sodium-Iodine Rechargeable Batteries.

Although the catalytic activity is heavily reliant on the electronic structure of the catalyst, understanding the impact of electron spin regulation on electrocatalytic performance is still rarely investigated. This work presents a novel approach involving the single-atom coordination of cobalt (Co) within metalloporphyrin-based three-dimensional covalent organic frameworks (3D-COFs) to facilitate the catalytic conversion for sodium-iodine batteries. The spin state of Co is modulated by altering the oxidation state of the porphyrin-centered Co, achieving optimal catalysis for iodine reduction. Experimental results demonstrate that CoII and CoIII are incorporated into the 3D-COFs, exhibiting spin ground states of S = 1/2 and S = 0, respectively. The low spin state of CoIII is favorable to hybridize with the sp 3d orbitals of I3-, thus facilitating the conversion of I3- to I-. Density-functional theory (DFT) calculations further reveal that the presence of CoIII enhances iodide adsorption and accelerates the formation of NaI in 3D-COFs-CoIII, thereby promoting its rapid kinetic behaviors. Notably, the I2@3D-COFs-CoIII cathode achieves a high reversible capacity of 227.7 mAh g-1 after 200 cycles at 0.5 C and demonstrates exceptional cyclic stability, exceeding 2000 cycles at 10 C with a minor capacity fading rate of less than one 0.01% per cycle.

3D-printed model is a useful addition in orthopedic resident education for the understanding of tibial plateau fractures.

This study aimed to explore the role of the three-dimension (3D) printed models in orthopedic resident training of tibial plateau fractures. A total of 41 residents from our institution were divided into two groups. The intervention group, consisting of 20 residents, had access to 3D-printed models illustrating thirteen tibial plateau fractures. In contrast, the control group, comprising 21 residents, received digital images of thirteen identical tibial plateau fractures. Evaluation of learning outcomes included the accurate identification of tibial plateau fracture patterns, deduction of traumatic mechanisms, preoperative plan, assessment time, and subjective questionnaire responses. The participants with 3D printed models scored significantly higher in both the Schatzker classification and Luo three-column classification compared to those without 3D printed models. Residents in the intervention group performed better in accuracy in deducing traumatic mechanisms compared to the control group. In addition, the sum score of preoperative plan in the intervention group was significantly higher than that in the control group. Specifically, participants with 3D printed models scored higher in surgical approach choice and implants placement than these in the control group. Residents exposed to 3D printed models also spent less time to complete the assessment than those with access only to digital imaging. Subjective assessments indicated that 3D-printed models boosted confidence in fracture identification, improved preoperative plan for fracture management and enhanced the understanding in injury mechanism of tibial plateau fractures. Furthermore, residents agreed that the use of 3D-printed models heightened their interest in learning tibial plateau fractures. Therefore, the addition of 3D printed models significantly contributed to a comprehensive understanding of tibial plateau fractures, the improvement in fracture identification, inferring injury mechanisms and preoperative plan.