Retrospective Analysis of 3D Printing-Assisted Surgical Outcomes in Chronic Coronal Shear Fractures of the Humeral Trochlea and Capitellum

Xiang Y., Li Y., Li L., Yucel H. C., Aksöyler D. Y., Dong J.

Indian Journal of Orthopaedics, 2025 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1007/s43465-025-01455-w
  • Dergi Adı: Indian Journal of Orthopaedics
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, CAB Abstracts, CINAHL
  • Anahtar Kelimeler: 3D-printed models, Chronic coronal shear fractures of the humeral trochlea and capitellum, Delayed fractures, Open reduction with internal fixation (ORIF)
  • İstanbul Üniversitesi Adresli: Evet

Özet

Objectives: Chronic capitellum–trochlea coronal shear fractures (defined as untreated injuries > 3 weeks) are complex intraarticular fractures of the distal humerus, primarily caused by missed diagnoses of low-energy trauma and typically requiring open reduction and internal fixation (ORIF). These articular fractures are associated with high complication rates, including nonunion and post-traumatic osteoarthritis. This retrospective analysis of ten patients evaluated the clinical efficacy of 3D printing-assisted ORIF in improving surgical precision and functional outcomes (assessed by Mayo Elbow Performance Score, MEPS) for chronic coronal shear fractures involving the humeral trochlea and capitellum. Methods: This retrospective study included ten patients with chronic coronal shear fractures treated with open reduction and internal fixation between September 2017 and September 2022. 3D-printed anatomical models were generated from CT scans using Medraw software to design patient-specific surgical strategies. Postoperative outcomes were assessed using the Mayo Elbow Performance Score (MEPS) by a blinded evaluator. Results: Patients ranged in age from 13 to 67 years (40.8 ± 17.2 years). All patients with closed fractures underwent surgery 5–16 weeks after injury (9.3 ± 3.6 weeks). No early postoperative complications, such as wound healing issues, were observed. Follow-up periods ranged from 8 to 12 months (9.7 ± 1.9 months), and bony union times averaged 12.9 ± 4.1 weeks (range, 8–19 weeks). No long-term complications, including instability or fixation loosening, were reported. The mean MEPS was 92.5 ± 8.2, with excellent results in seven cases and good results in three cases. Conclusions: 3D printing may aid in developing precise, patient-specific surgical plans, potentially improving articular reduction accuracy and minimizing intraoperative challenges in treating chronic coronal shear fractures of the humeral trochlea and capitellum.