Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand.
Biomechanics Research Center, Meticuly Co. Ltd., 26683Chulalongkorn University, Bangkok, Thailand.
J Orthop Surg (Hong Kong). 2020 Sep-Dec;28(3):2309499020960251. doi: 10.1177/2309499020960251.
The open distal humeral fracture associated with the major loss of the articular surface and bony structure is a challenging problem for orthopedic surgeons. In this case report, we describe a case of complete missing lateral column of the distal humerus with severe articular destruction of capitellum and lateral trochlear ridge which was treated with the patient-specific implant created with three-dimensional printing technology. Apart from anatomic replacement of the articular surface, the lateral collateral ligament complex and extensor muscle which are the key soft tissue stabilizers of elbow were repaired by reattaching their bony origins to the impacted iliac crest bone graft inside the implant. Due to the favorable result at 2-year follow-up, this modality is a potentially viable surgical option in treating of the severe open distal humeral fracture associated with entire lateral condylar damage.
肱骨远端开放性骨折伴关节面和骨结构大量丢失，是骨科医生面临的一个挑战。在本病例报告中，我们描述了一例肱骨远端外侧柱完全缺失伴滑车外侧嵴和头状骨严重关节破坏的病例，采用三维打印技术制作的个体化植入物进行治疗。除了关节面的解剖重建外，通过将外侧副韧带复合体和伸肌的骨性起点重新附着到植入物内的髂嵴骨移植物上，修复了这些作为肘部关键软组织稳定器的结构。由于 2 年随访结果良好，这种方法可能成为治疗严重伴整个外侧髁损伤的开放性肱骨远端骨折的一种可行的手术选择。
