A Customized 3D-Printed Splint for Stabilization of an Open Front Flipper Fracture in a Green Sea Turtle (Chelonia mydas)
Emily F. Christiansen1; Denis J. Marcellin-Little2,3; Austin Isaacs3; Timothy J. Horn3; Ronald L. Aman3; Christian Legner4; Craig A. Harms1*
Sea turtles frequently present to veterinarians and rehabilitation centers with traumatic injuries caused by boat strikes or similar impacts. These injuries commonly include fractures of the extremities, with or without open wounds. While sea turtles have an impressive capacity to heal without significant intervention, the preservation of maximal function in these flippers is a priority for successful return to the wild. Various forms of surgical and external coaptation have been attempted in sea turtles, with limited success. Their natural saltwater environment is not conducive to typical bandaging and splinting materials, and the forces applied against a flipper in the aquatic medium are substantial enough to cause most types of surgical fixators to fail, even in smaller individuals.
In July 2013, a juvenile green sea turtle was found floating at the surface in near-shore waters of central North Carolina. The turtle had sustained an open fracture of the right radius and ulna with ventral exposure of bone fragments, along with other injuries. The flipper exhibited severe dorso-flexion at the fracture site. The tissue distal to the injury retained adequate circulation and nervous function.
A 3-D printer was used to create a customized form-fitting plastic polymer splint designed using modeling software around CT-derived tridimensional renderings of the fractured and intact flippers. The splint was generated in a two-piece clamshell design with multiple perforations, with a hinge along the cranial edge, and included a large window over the open wound to allow for cleaning and monitoring. The splint was initially applied under sedation, and secured onto the flipper with synthetic suture material. The turtle tolerated the splint very well, and showed increased swimming confidence within minutes of being placed in the water. The splint remained in place for 40 days, providing considerable external stabilization with no obvious side effects.
The authors thank the aquarists of North Carolina Aquarium on Roanoke Island and the volunteers of the Network for Endangered Sea Turtles (NEST) for their dedicated and ongoing care of this and many other sea turtle rehabilitation patients. They also thank Heather Broadhurst for extensive technical assistance.
* Presenting author