The Patient-Specific Implant Created with 3D Printing Technology in Treatment of the Irreparable Radial Head in Chronic Persistent Elbow Instability

Suriya Luenam,Boonrat Lohwongwatana,Chedtha Puncreobutr,Arkaphat Kosiyatrakul,Chanon Hansudewechakul,Kantapat Phakdeewisetkul

doi:10.1155/2018/9272075

Suriya Luenam, Boonrat Lohwongwatana + Show 4 more

Open Access

https://doi.org/10.1155/2018/9272075

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Abstract

Successful treatment of the chronic persistent elbow instability is a challenge for orthopedic surgeons. In this form, it is important to recognize and restore the osseous stabilizer in order to obtain the concentric reduction. In the present report, we describe a case of such injury with irreparable radial head treated with patient-specific radial head prosthesis which was created with 3D printing technology. To our knowledge, this is the first report in clinical use of this kind of prosthesis for the radial head fracture. At a 24-month follow-up visit, the patient was satisfied with the functional outcomes. The Mayo Elbow Performance Index (MEPI) increased from 20 points at the preoperative day to 85 points, and the patient-based Disabilities of the Arm, Shoulder, and Hand (DASH) was reduced from 88.33 points to 28.33 points. Due to the favorable result, replacement of the radial head with the patient-specific implant could be a useful treatment for the irreparable radial head in chronic persistent elbow instability.

Highlights

The chronic persistent elbow instability which has the association of injury of bony and soft tissue stabilizers is one of the most difficult cases to solve and always attributed to the severely restricting function when the treatment is inadequate [1,2,3]
We describe a case of chronic persistent elbow instability with irreparable radial head treated with patient-specific radial head prosthesis which was created with 3D printing technology
Once the reconstruction of computerized radial head prosthesis was completed, a STL file was generated for fabrication of resin-customized implant using the stereolithography (SLA) technique

Summary

Introduction

The chronic persistent elbow instability which has the association of injury of bony and soft tissue stabilizers is one of the most difficult cases to solve and always attributed to the severely restricting function when the treatment is inadequate [1,2,3]. This is a real challenging problem even for the most skilled orthopedic surgeons. The radial neck-diaphysis angle and offset from the axis are variable [6,7,8] For this reason, a radial head hemiarthroplasty that precisely replicates the native bone shape would be difficult to achieve [6]. We describe a case of chronic persistent elbow instability with irreparable radial head treated with patient-specific radial head prosthesis which was created with 3D printing technology

Case Report

Findings

Discussion