Gutierrez-Pereira Javier, Vera-Gimenez Eva, Madrigal-Quevedo Alejandro, Garcia-Lopez Antonio
Department of Orthopaedic Surgery, Hospital General Universitario de Alicante (Spanish National Reference Center for Brachial Plexus Surgery), Alicante, Spain.
Am J Case Rep. 2025 Jun 11;26:e947299. doi: 10.12659/AJCR.947299.
BACKGROUND Preoperative planning is crucial for orthopedic interventions, particularly in the correction of severe deformities. Correct implant selection, positioning, and osteotomy planning are essential to achieving optimal surgical outcomes. Recent advancements in 3D printing technology, including the development of calcium-density models, have enhanced visualization and surgical precision. This case study demonstrates the application of this innovative approach in managing a complex proximal humerus deformity in a pediatric patient. CASE REPORT We describe the case of an 8-year-old girl with a severe proximal humerus varus deformity secondary to epiphysiolysis. Her condition was characterized by a cervico-diaphyseal angle of 68° and limited shoulder abduction to 60°. A 3D calcium-density model was employed for meticulous preoperative planning, enabling precise assessment of the deformity, optimization of implant positioning, and accurate osteotomy execution. The surgical procedure consisted of a 15-mm wedge valgus osteotomy using an iliac crest graft and fixation with a PediLoc® plate. This approach achieved a correction of the cervico-diaphyseal angle to 140°, restored shoulder abduction to 180°, and limited the overall surgical time to 2 hours. CONCLUSIONS The use of 3D printing with calcium carbonate-enhanced polylactic acid (PLA) provided superior visualization, radiographic assessment capabilities, and preoperative plate contouring, enhancing surgical efficiency and improving clinical outcomes. The radiopaque properties of the material facilitated intraoperative radiological verification, ensuring precision and safety. This case underscores the potential of this technology to streamline complex pediatric orthopedic surgeries, minimize intraoperative challenges, and improving patient outcomes. Further research is warranted to validate its broader application in orthopedic practice.
背景 术前规划对于骨科手术干预至关重要，尤其是在严重畸形矫正中。正确选择植入物、确定其位置以及进行截骨术规划对于实现最佳手术效果至关重要。3D打印技术的最新进展，包括钙密度模型的开发，增强了可视化效果和手术精度。本病例研究展示了这种创新方法在治疗一名小儿患者复杂肱骨近端畸形中的应用。病例报告 我们描述了一名8岁女孩的病例，她因骨骺溶解继发严重肱骨近端内翻畸形。其病情表现为颈干角为68°，肩关节外展受限至60°。使用3D钙密度模型进行细致的术前规划，能够精确评估畸形、优化植入物位置并准确执行截骨术。手术过程包括使用髂嵴植骨进行15毫米楔形外翻截骨术，并使用PediLoc®钢板固定。该方法将颈干角矫正至140°，恢复肩关节外展至180°，并将总手术时间限制在2小时。结论 使用碳酸钙增强聚乳酸（PLA）的3D打印提供了卓越的可视化效果、影像学评估能力和术前钢板塑形，提高了手术效率并改善了临床结果。该材料的不透射线特性便于术中进行放射学验证，确保了精确性和安全性。本病例强调了该技术在简化复杂小儿骨科手术、减少术中挑战以及改善患者预后方面的潜力。有必要进行进一步研究以验证其在骨科实践中的更广泛应用。
