Prebending of osteosynthesis plate using 3D printed models to treat symptomatic os acromiale and acromial fracture

Abstract

BackgroundA symptomatic os acromiale can lead to impingement syndrome and rotator cuff tendinopathy. An acromion fracture is often part of a more complex scapular trauma that needs stabilisation.MethodsWe developed a new technique using a three-dimensional (3D) model and a distal clavicle reconstruction plate to treat os acromiale and acromion fractures. Our hypothesis was that such an approach would be a useful addition to the existing techniques. First, a 3D model of the acromion was printed, then an osteosynthesis plate was pre-bent to fit the exact shape and curve of the acromion. We tested this technique and present reports on five patients, three with os acromiales and two with acromial fractures. We followed these patients during their rehabilitation and evaluated them using the Constant–Murley and the Disabilities of the Arm, Shoulder and Hand scores.ResultsIn every case the fracture or non-union healed. If the surgery was performed before additional damage (such as an impingement syndrome) occurred, we saw that the patient’s pain completely disappeared. This new technique also has other advantages because the surgeon can prepare the entire operation in advance, which reduces the duration of surgery. Another advantage of using a 3D model is that it can also be used to inform the patient and the surgical team about the planned operation.ConclusionThis new technique using a preoperative patient-customized plate is a good alternative for use in open reduction and internal fixation, particularly if the patient has no other conditions.

Clinical results and complications following surgical management of symptomatic os acromiale: a systematic review

“…Open reduction and internal fixation was the most frequently performed surgery, accounting for 57% of the included cases (126 of 221 cases) [3, 5, 11–21]. Procedures performed within this category included internal fixation using Kirshner wires ( n = 57) [3, 11, 14, 17], screws ( n = 56) [5, 11, 12, 15, 18–21], plates ( n = 5) [16], and absorbable screws ( n = 8) [13]. A tension band construct was most commonly utilized (100 of 113 cases; 88%), whereby inter-fragmentary compression was obtained using two parallel Kirshner wires or cannulated screws combined with a cerclage or figure-of-eight wire [3, 11, 12, 14, 15, 17, 21] or suture [19, 20].…”

Open reduction internal fixation of acromion fracture with open rotator cuff repair: a case report

“… 6 Using a 3D model of a patient's acromion and prebending an osteosynthesis plate to fit the curvature of the acromion has also been reported. 3 …”

Finding NEEMO: towards organizing smart digital solutions in orthopaedic trauma surgery

“…Stages five and six are tissue prints and hybrid/composite prints of different tissues and materials. 63 , 64 3D printed solutions have been described for almost every bone and joint: acromion, 65 clavicle, 53 , 66 glenoid, 62 humerus, 58 , 61 , 67 – 69 radius, 56 , 70 pelvis, 71 – 74 spine, 75 , 76 femur, 54 , 55 , 77 – 80 tibia, 81 – 85 calcaneus, 86 , 87 talus, 88 and the ankle. 57 …”