Streck LE, Straub A, Boettner F, Rudert M, List K. [Treatment of symptomatic pseudarthrosis following acromion fracture with a patient-specific implant customized on a 3D-printed scapula].
OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE 2023;
35:270-277. [PMID:
37380895 DOI:
10.1007/s00064-023-00817-7]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/30/2022] [Accepted: 11/03/2022] [Indexed: 06/30/2023]
Abstract
OBJECTIVE
Patient-specific osteosynthesis for pseudarthrosis of the acromion.
INDICATIONS
Symptomatic pseudarthrosis of the acromion at the level of a meta/mesacromion.
CONTRAINDICATIONS
Infection; patient noncompliance regarding postoperative treatment protocol.
SURGICAL TECHNIQUE
Preoperatively, a patient-specific three-dimensional model of the scapula is printed. A locking compression plate (LCP) is individually adapted to this model. Via a dorsal surgical approach over the scapular spine, the pseudarthrosis is refreshed and autologous cancellous bone from the iliac crest is embedded in the fracture zone. This is followed by fixed-angle osteosynthesis with the individualized plate. In addition, tension banding with tapes is performed to reduce the tensile and shear forces on the fracture caused by the muscle.
POSTOPERATIVE MANAGEMENT
Consistent wearing of a shoulder-arm brace for 6 weeks postoperatively, active-assisted increase in range of motion for an additional 3 weeks, then gradual increase in weight-bearing and initiation of daily activities without additional weights until 12 weeks postoperatively.
RESULTS
Treatment with the presented technique resulted in radiographic consolidation of the fracture and significant improvement in range of motion and pain at the 1‑year follow-up.
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