Bilateral pelvic osteotomy for malunion of a vertical shear fracture with 3D-printed patient-specific cutting guides: a case report.
3D model
Malunion
Patient-specific guides
Pelvic malunion
Pelvic osteotomy
Vertical shear
Journal
European journal of orthopaedic surgery & traumatology : orthopedie traumatologie
ISSN: 1432-1068
Titre abrégé: Eur J Orthop Surg Traumatol
Pays: France
ID NLM: 9518037
Informations de publication
Date de publication:
27 Sep 2024
27 Sep 2024
Historique:
received:
31
07
2024
accepted:
22
09
2024
medline:
27
9
2024
pubmed:
27
9
2024
entrez:
27
9
2024
Statut:
aheadofprint
Résumé
Pelvic osteotomies present a surgical option to restore pelvic alignment, improve function and pain in sequelae of pelvic ring fractures. Understanding the three-dimensional deformity is a crucial step within preoperative planning; furthermore, accurate intraoperative execution of the planning can be challenging. In recent years, patient-specific guides and 3D modeling have emerged as promising technologies in orthopedic and trauma surgery to enhance surgical precision and facilitate intraoperative decision-making. We present the case of a 41-year-old male patient with a pelvic malunion, resulting from a vertical shear fracture occurring 8 years prior. The patient presented with a 4-cm cranial displacement of the right hemipelvis, accompanied by pubic symphysis disruption and fusion of S1 to L5 vertebra. Severely altered posture in the coronal and sagittal plane was associated with sitting imbalance, impaired gait, and chronic pain. We analyzed the deformity and planned the surgical correction on a 3D interactive virtual model. Moreover, we developed 2 patient-specific cutting guides and one patient-specific reduction guide, allowing accurate bilateral pelvic osteotomies, subsequent realignment, and restoration of the pelvic anatomy. For the first time, 3D modeling and 3D-printed patient-specific guides were effectively employed in pelvic malunion surgery, enhancing the precision of preoperative planning, and providing valuable assistance during intraoperative procedures.
Identifiants
pubmed: 39331135
doi: 10.1007/s00590-024-04109-z
pii: 10.1007/s00590-024-04109-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
Références
Court-Brown CM, Caesar B (2006) Epidemiology of adult fractures: a review. Injury 37:691–697. https://doi.org/10.1016/j.injury.2006.04.130
doi: 10.1016/j.injury.2006.04.130
pubmed: 16814787
Freitas CD, Garotti JER, Nieto J et al (2013) There have been changes in the incidence and epidemiology of pelvic ring fractures in recent decades? Rev Bras Ortop 48:475–481. https://doi.org/10.1016/j.rboe.2013.12.013
doi: 10.1016/j.rboe.2013.12.013
pubmed: 31304157
pmcid: 6565988
Melhem E, Riouallon G, Habboubi K et al (2020) Epidemiology of pelvic and acetabular fractures in France. Orthop Traumatol Surg Res 106:831–839. https://doi.org/10.1016/j.otsr.2019.11.019
doi: 10.1016/j.otsr.2019.11.019
pubmed: 32019733
Burgess AR, Eastridge BJ, Young JW et al (1990) Pelvic ring disruptions: effective classification system and treatment protocols. J Trauma 30:848–856
doi: 10.1097/00005373-199007000-00015
pubmed: 2381002
Blum L, Hake ME, Charles R et al (2018) Vertical shear pelvic injury: evaluation, management, and fixation strategies. Int Orthop 42:2663–2674. https://doi.org/10.1007/s00264-018-3883-1
doi: 10.1007/s00264-018-3883-1
pubmed: 29582114
Oransky M, Tortora M (2007) Nonunions and malunions after pelvic fractures: why they occur and what can be done? Injury 38:489–496. https://doi.org/10.1016/j.injury.2007.01.019
doi: 10.1016/j.injury.2007.01.019
pubmed: 17400228
Stine S, Washington A, Sen RK et al (2022) Pelvic malunion: a systematic review, dichotomy of definitions and treatment. Medicina (Kaunas) 58:1098. https://doi.org/10.3390/medicina58081098
doi: 10.3390/medicina58081098
pubmed: 36013565
Taguchi T, Kawai S, Kaneko K, Yugue D (2000) Surgical treatment of old pelvic fractures. Int Orthop 24:28–32. https://doi.org/10.1007/s002640050007
doi: 10.1007/s002640050007
pubmed: 10774858
pmcid: 3619861
Sancineto CF, Gimenez MV, Taype D et al (2020) A novel radiological projection of the pelvis to evaluate the sitting imbalance in pelvis nonunions and malunions. J Clin Orthop Trauma 11:1117–1120. https://doi.org/10.1016/j.jcot.2020.10.010
doi: 10.1016/j.jcot.2020.10.010
pubmed: 33192017
pmcid: 7656520
Luo Y, He L, Li Y et al (2022) Sacral osteotomy combined with triangular osteosynthesis in the treatment of malunion and nonunion of vertically displaced pelvic fractures. J Orthop Surg Res 17:409. https://doi.org/10.1186/s13018-022-03296-x
doi: 10.1186/s13018-022-03296-x
pubmed: 36064584
pmcid: 9446817
Wixted CM, Peterson JR, Kadakia RJ, Adams SB (2021) Three-dimensional printing in orthopaedic surgery: current applications and future developments. J Am Acad Orthop Surg Glob Res Rev 5:e20.00230-00211. https://doi.org/10.5435/JAAOSGlobal-D-20-00230
doi: 10.5435/JAAOSGlobal-D-20-00230
pubmed: 33877073
Kotrych D, Angelini A, Bohatyrewicz A, Ruggieri P (2023) 3D printing for patient-specific implants in musculoskeletal oncology. EFORT Open Rev 8:331–339. https://doi.org/10.1530/EOR-23-0066
doi: 10.1530/EOR-23-0066
pubmed: 37158428
pmcid: 10233802
Richard RD, Heare A, Mauffrey C et al (2023) Use of 3D printing technology in fracture management: a review and case series. J Orthop Trauma 37:S40–S48. https://doi.org/10.1097/BOT.0000000000002693
doi: 10.1097/BOT.0000000000002693
pubmed: 37828701
Aiba H, Spazzoli B, Tsukamoto S et al (2023) Current concepts in the resection of bone tumors using a patient-specific three-dimensional printed cutting guide. Curr Oncol 30:3859–3870. https://doi.org/10.3390/curroncol30040292
doi: 10.3390/curroncol30040292
pubmed: 37185405
pmcid: 10136997
Brackertz S, Reissner L, Fritz B et al (2023) Fixed subluxation of the distal radioulnar joint following malunion of the ulnar styloid process. J Wrist Surg 12:199–204. https://doi.org/10.1055/s-0042-1750872
doi: 10.1055/s-0042-1750872
pubmed: 37223387
Huang Q, Chen Z, Li B, Yang B (2023) Three-dimensional digital technology: a powerful assistant for the reconstruction of complex craniofacial deformities. J Craniofac Surg. https://doi.org/10.1097/SCS.0000000000009644
doi: 10.1097/SCS.0000000000009644
pubmed: 37983376
pmcid: 10597431
Rosso F, Rossi R, Neyret P et al (2023) A new three-dimensional patient-specific cutting guide for opening wedge high tibial osteotomy based on ct scan: preliminary in vitro results. J Exp Orthop 10:80. https://doi.org/10.1186/s40634-023-00647-3
doi: 10.1186/s40634-023-00647-3
pubmed: 37556100
pmcid: 10412513
Van Genechten W, De Cock L, Sys J, van den Broek M (2023) A novel patient-specific 3D printed guide for accurate femoral derotation osteotomies: a case report. Ann Transl Med 11:268. https://doi.org/10.21037/atm-22-1645
doi: 10.21037/atm-22-1645
pubmed: 37082698
pmcid: 10113089
Zaffagnini S, Dal Fabbro G, Lucidi GA et al (2023) Personalised opening wedge high tibial osteotomy with patient-specific plates and instrumentation accurately controls coronal correction and posterior slope: results from a prospective first case series. Knee 44:89–99. https://doi.org/10.1016/j.knee.2023.07.011
doi: 10.1016/j.knee.2023.07.011
pubmed: 37562120
Cattaneo S, Domenicucci M, Galante C et al (2023) Use of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunion. 3D Print Med 9:24. https://doi.org/10.1186/s41205-023-00184-w
doi: 10.1186/s41205-023-00184-w
pubmed: 37672114
pmcid: 10481603
Matta JM, Yerasimides JG (2007) Table-skeletal fixation as an adjunct to pelvic ring reduction. J Orthop Trauma 21:647–656. https://doi.org/10.1097/BOT.0b013e31809810e5
doi: 10.1097/BOT.0b013e31809810e5
pubmed: 17921841
Aman ZS, DePhillipo NN, Peebles LA et al (2022) Improved accuracy of coronal alignment can be attained using 3D-printed patient-specific instrumentation for knee osteotomies: a systematic review of level III and IV studies. Arthroscopy 38:2741–2758. https://doi.org/10.1016/j.arthro.2022.02.023
doi: 10.1016/j.arthro.2022.02.023
pubmed: 35247513