Use of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunion
Abstract Background Scapular osteotomy for malunion can lead to resolution of pain and functional improvement in scapula fracture sequelae. Understanding three-dimensional bone morphology and analysing post-traumatic deformity is the main step of planning and the key to success of the procedure. 3D...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-09-01
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| Series: | 3D Printing in Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s41205-023-00184-w |
| _version_ | 1827635596107972608 |
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| author | Stefano Cattaneo Marco Domenicucci Claudio Galante Elena Biancardi Alessandro Casiraghi Giuseppe Milano |
| author_facet | Stefano Cattaneo Marco Domenicucci Claudio Galante Elena Biancardi Alessandro Casiraghi Giuseppe Milano |
| author_sort | Stefano Cattaneo |
| collection | DOAJ |
| description | Abstract Background Scapular osteotomy for malunion can lead to resolution of pain and functional improvement in scapula fracture sequelae. Understanding three-dimensional bone morphology and analysing post-traumatic deformity is the main step of planning and the key to success of the procedure. 3D models and patient-specific guides are a growing technology to enhance accuracy of planning and to assist during surgery. Case presentation We report the case of a 50 years old male, complaining of pain and limited function after a malunited scapular body fracture. Clinical assessment showed a severe impairment of shoulder function with active and passive forward flexion limited to 80°, absent external rotation, and internal rotation limited to the buttock. X-rays and CT scan showed an excessive lateral border offset of 53 mm and complete displacement of the glenoid segment anteriorly and medially to the scapular body, with impingement between the lateral most prominent scapular bone spur and humeral shaft. Glenopolar angle was 19°, scapular body angulation on the sagittal plane was 12°. Corrective osteotomy was planned on a virtual interactive rendering and on 3D printed models. Patient-specific guides were developed to perform a body-spine osteotomy with removal of a bone wedge, and a glenoid-spine osteotomy; a patient-specific wedge spacer was used to hold the reduction during plate fixation. Follow-up up to 12 months after surgery demonstrated improvement in scapula anatomy, shoulder girdle function, and patient-reported outcomes. Conclusions For the first time in scapula malunion surgery, patient-specific osteotomy guides were succesfully used during surgery to perform osteotomies and to assist in reduction maneuvers. |
| first_indexed | 2024-03-09T15:28:50Z |
| format | Article |
| id | doaj.art-ff6dbd8717af47aebfea21d2d4952df0 |
| institution | Directory Open Access Journal |
| issn | 2365-6271 |
| language | English |
| last_indexed | 2024-03-09T15:28:50Z |
| publishDate | 2023-09-01 |
| publisher | BMC |
| record_format | Article |
| series | 3D Printing in Medicine |
| spelling | doaj.art-ff6dbd8717af47aebfea21d2d4952df02023-11-26T12:23:17ZengBMC3D Printing in Medicine2365-62712023-09-019111210.1186/s41205-023-00184-wUse of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunionStefano Cattaneo0Marco Domenicucci1Claudio Galante2Elena Biancardi3Alessandro Casiraghi4Giuseppe Milano5Department of Bone and Joint Surgery, ASST Spedali CiviliDepartment of Bone and Joint Surgery, ASST Spedali CiviliDepartment of Bone and Joint Surgery, ASST Spedali CiviliDepartment of Bone and Joint Surgery, ASST Spedali CiviliDepartment of Bone and Joint Surgery, ASST Spedali CiviliDepartment of Bone and Joint Surgery, ASST Spedali CiviliAbstract Background Scapular osteotomy for malunion can lead to resolution of pain and functional improvement in scapula fracture sequelae. Understanding three-dimensional bone morphology and analysing post-traumatic deformity is the main step of planning and the key to success of the procedure. 3D models and patient-specific guides are a growing technology to enhance accuracy of planning and to assist during surgery. Case presentation We report the case of a 50 years old male, complaining of pain and limited function after a malunited scapular body fracture. Clinical assessment showed a severe impairment of shoulder function with active and passive forward flexion limited to 80°, absent external rotation, and internal rotation limited to the buttock. X-rays and CT scan showed an excessive lateral border offset of 53 mm and complete displacement of the glenoid segment anteriorly and medially to the scapular body, with impingement between the lateral most prominent scapular bone spur and humeral shaft. Glenopolar angle was 19°, scapular body angulation on the sagittal plane was 12°. Corrective osteotomy was planned on a virtual interactive rendering and on 3D printed models. Patient-specific guides were developed to perform a body-spine osteotomy with removal of a bone wedge, and a glenoid-spine osteotomy; a patient-specific wedge spacer was used to hold the reduction during plate fixation. Follow-up up to 12 months after surgery demonstrated improvement in scapula anatomy, shoulder girdle function, and patient-reported outcomes. Conclusions For the first time in scapula malunion surgery, patient-specific osteotomy guides were succesfully used during surgery to perform osteotomies and to assist in reduction maneuvers.https://doi.org/10.1186/s41205-023-00184-wScapulaMalunion3D modelPatient-specific guides |
| spellingShingle | Stefano Cattaneo Marco Domenicucci Claudio Galante Elena Biancardi Alessandro Casiraghi Giuseppe Milano Use of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunion 3D Printing in Medicine Scapula Malunion 3D model Patient-specific guides |
| title | Use of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunion |
| title_full | Use of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunion |
| title_fullStr | Use of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunion |
| title_full_unstemmed | Use of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunion |
| title_short | Use of patient-specific guides and 3D model in scapula osteotomy for symptomatic malunion |
| title_sort | use of patient specific guides and 3d model in scapula osteotomy for symptomatic malunion |
| topic | Scapula Malunion 3D model Patient-specific guides |
| url | https://doi.org/10.1186/s41205-023-00184-w |
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