Three-dimensional printing designed customized plate in the treatment of coronal fracture of distal humerus in teenager: A case report

Abstract

Rationale: Because of the complicated anatomy and considerable change in size and morphology with age in teenagers, the appropriate internal fixator of coronal shear fracture of distal humerus is difficult to choose, and therefore, the fixation of this kind of fracture is difficult and controversial. Furthermore, distal humeral fractures in teenagers often involve the epiphysis, the rigid fixation of fracture and the simultaneous minimally invasive and protection of the epiphysis are contradictory. Coronal shear fractures of the distal humerus in teenagers are great challenge for orthopedic surgeons. Three-dimensional (3D) printing designed customized plate in the treatment of coronal fracture of distal humerus in teenager is a potential satisfactory choice in the treatment of the complex fractures. Patient concerns: A teenager suffered from an elbow joint injury due to a fall while running, resulting in pain, swelling and limited movement of the elbow joint. The epiphyseal has not closed in this patient, conventional surgical procedures have great traumatic and invasive, and to some extent affect bone growth in children. Diagnoses: Coronal shear fracture of right distal humerus according to computed tomography scan. Interventions: We used 3D printing technology to design an internal fixation device for this patient, which was to treat the distal humeral coronal shear fracture in a teenager via an anterior approach to the elbow joint, and finally the child was instructed to perform immediate postoperative functional exercises and rehabilitation. Outcomes: Radiographic reexamination performed 1 day and 2 month after the operation showed that the internal fixation was in good position, no fracture displacement. the patient was instructed to perform active flexion and extension internal and external rotation of the right elbow 6 weeks postoperatively. The Mayo elbow function score was excellent 5 months postoperatively. The range of motion of the elbow was (15°–130°) Lessons: The treatment of coronal shear fractures of the distal humerus in teenager is controversial at present. This report 3D printing technology designed customized plate in treatment of such fractures showed satisfactory results, which provides a feasible method for the treatment of fractures without suitable internal fixation devices in the future.

Shear fractures of the capitellum in children: a case report and narrative review

“…We carried out a narrative review of the pediatric literature for capitellar shear fractures (shown in Table 1 ). Most of the literature consists of case reports ( 5 – 8 , 13 , 16 , 17 , 20 – 23 , 25 – 27 , 29 – 31 , 33 , 38 ), followed by a smaller number of retrospective case series ( 9 , 18 , 19 , 24 , 28 , 32 , 34 – 37 ). The retrieved literature showed a bimodal distribution of these fractures, with a first peak in childhood (<10 years) ( 7 , 17 , 20 , 31 ) and a second one, the most representative, in pre-adolescents and adolescents ( 5 – 9 , 13 , 16 , 18 , 19 , 21 – 25 , 27 – 30 , 32 – 38 ).…”

“…Most of the literature consists of case reports ( 5 – 8 , 13 , 16 , 17 , 20 – 23 , 25 – 27 , 29 – 31 , 33 , 38 ), followed by a smaller number of retrospective case series ( 9 , 18 , 19 , 24 , 28 , 32 , 34 – 37 ). The retrieved literature showed a bimodal distribution of these fractures, with a first peak in childhood (<10 years) ( 7 , 17 , 20 , 31 ) and a second one, the most representative, in pre-adolescents and adolescents ( 5 – 9 , 13 , 16 , 18 , 19 , 21 – 25 , 27 – 30 , 32 – 38 ). The most frequent associated injury was the ipsilateral elbow dislocation, followed by the involvement of the medial or lateral condyle, or an olecranon or radial head fracture ( 5 , 16 , 17 , 21 , 31 , 37 , 38 ).…”