An Individualized Intra-Articular Stabilization Device Designed Based on 3D Printing Technology for Traumatic Instability of the Ulnohumeral Joint.

Rong-Feng She,Qi-Xiang Huang,Yi Zhang,Bin Zhang,Yuan-Zheng Wang,Cem Kopuz

doi:10.1155/2020/3056395

Rong-Feng She, Qi-Xiang Huang + Show 4 more

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https://doi.org/10.1155/2020/3056395

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Abstract

We aimed to design an individualized intra-articular stabilization device based on 3D printing technology and investigate the clinical effects of this device for treating traumatic instability of the ulnohumeral joint. This study enrolled nine patients with traumatic instability of the ulnohumeral joint (age: 47.2 ± 1.80 years) who received treatment between March 2018 and March 2019 in our hospital. All patients underwent a thin-layer computed tomography (CT) scan of the elbow before surgery. The original injury and repair models of the elbow were printed using 3D printing technology based on CT data. An individualized intra-articular stabilization device was designed with a 2.0 mm Kirschner wire based on the repair model. Nine patients agreed to receive surgical treatment for elbow disease and placement of the intra-articular stabilization device. The nine patients underwent open reduction through a posterior median approach, and the intra-articular stabilization device was placed in the elbow. Operation time, intraoperative blood loss, and postoperative complications were recorded and followed up. The device was removed at two postoperative months, and the Mayo score was used to evaluate elbow function. Four months after removing the intra-articular stabilization device, elbow joint function was evaluated again using the Mayo score. The mean operation time was 100.1 ± 8.2 min, and the mean intraoperative blood loss was 35.5 ± 7.1 ml. No complications occurred after operation. Two months after surgery, eight patients received an excellent Mayo score, and one patient received a good Mayo score. Four months after removal of the intra-articular stabilization device, eight patients received an excellent Mayo score, and one patient received a good Mayo score. The individualized intra-articular stabilization device can increase ulnohumeral stability and achieve rapid functional recovery of the elbow.

Highlights

The elbow is composed of bones and ligaments, and the ulnohumeral joint primarily participates in the flexion and extension of the elbow
A 3D model of the elbow repair can be used to design an individualized intra-articular stabilization device for ulnohumeral instability caused by elbow dislocation or terrible triad of the elbow
Compared with external fixation with plaster support, external brace fixation, and a hinged external fixator, the application of an intra-articular stabilization device can effectively reduce the incidence of elbow stiffness

Summary

Introduction

The elbow is composed of bones and ligaments, and the ulnohumeral joint primarily participates in the flexion and extension of the elbow. A hinged external fixator with an elbow brace has achieved good clinical results for treating elbow instability. External fixation with a plaster cast or elbow brace does not allow early functional exercise and may result in elbow stiffness [5]. A multicenter randomized controlled study concluded that this method allows elbow movement, but it increases elbow stability and has a good clinical effect. Pasternack et al [8] used an internal joint stabilizer to treat traumatic elbow instability and achieved good clinical effects. Clinical studies have indicated that 3D printing technology is used to assist in designing new internal stabilization devices, which can increase ulnohumeral stability, allow the elbow to move along the elbow rotation center, enable the elbow to perform exercises earlier, and achieve rapid rehabilitation after elbow joint injury

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