Luenam Suriya, Kosiyatrakul Arkaphat, Hansudewechakul Chanon, Phakdeewisetkul Kantapat, Lohwongwatana Boonrat, Puncreobutr Chedtha
Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
Department of Metallurgical Engineering, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
Case Rep Orthop. 2018 Oct 23;2018:9272075. doi: 10.1155/2018/9272075. eCollection 2018.
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.
成功治疗慢性持续性肘关节不稳对骨科医生来说是一项挑战。对于这种情况，认识并恢复骨稳定结构以实现同心圆复位很重要。在本报告中，我们描述了一例桡骨头无法修复的此类损伤病例，采用3D打印技术制作的定制桡骨头假体进行治疗。据我们所知，这是此类假体用于桡骨头骨折临床应用的首例报告。在24个月的随访中，患者对功能结果满意。梅奥肘关节功能指数（MEPI）从术前的20分提高到85分，基于患者的上肢、肩部和手部功能障碍评分（DASH）从88.33分降至28.33分。鉴于良好的结果，使用定制植入物置换桡骨头可能是治疗慢性持续性肘关节不稳中无法修复的桡骨头的一种有效方法。
