Using 3D Printing Technology to Design Split‐Piece Sleeve Prosthesis in the Revision Surgery of Tumor‐Type Total Elbow Prosthetic Fractures: A Case Report

TL;DR

A 3D printed split-piece sleeve prosthesis was used to successfully repair a fractured elbow implant in a patient with a bone tumor, showing good long-term results.

Contribution

A novel revision technique using 3D printing for tumor-type elbow prosthesis fractures is presented.

Findings

The 3D printed prosthesis remained securely in place without loosening over a 2-year follow-up.

Functional scores (MEPS and MSTS) indicated favorable outcomes after the revision surgery.

The elbow's range of motion improved significantly post-treatment.

Abstract

Revision of tumor‐type prosthetic fractures is very challenging in clinical work. Traditional repair methods may not be able to meet the needs of complex cases or cause greater bone damage. Therefore, more effective and reliable solutions need to be found.

This study presents a novel revision technique for managing fractures of tumor‐type total elbow prostheses. A 57‐year‐old female patient was diagnosed with a left distal humeral bone tumor accompanied by pathological fracture and underwent customized tumor‐type total elbow prosthesis arthroplasty. After 5 years, she experienced pain and encountered difficulty in flexing the left elbow while lifting heavy objects. The X‐ray examination revealed a fracture of the distal humeral prosthesis. As a response, the elbow joint was initially explored, and the damaged component of the prosthesis was extracted. Subsequently, we utilized 3D printing technology to design a split‐piece sleeve prosthesis and effectively restored the fractured left distal humerus implant. During the 2‐year follow‐up, The X‐ray demonstrated satisfactory positioning of the prosthesis, which remained securely affixed without any indications of loosening. The Mayo Elbow Performance Score (MEPS) reached 80 points, the Musculoskeletal Tumor Society (MSTS) attained a score of 28 points, and the range of motion of the elbow was measured between 25° and 110°, revealing favorable functional outcomes.

The utilization of a 3D printed split‐piece sleeve prosthesis presents a viable clinical treatment strategy for addressing fractures in tumor‐type elbow prostheses.

A 57‐year‐old female patient was diagnosed with a left distal humeral bone tumor accompanied by pathological fracture and underwent customized tumor‐type total elbow prosthesis arthroplasty. After 5 years, the X‐ray examination revealed a fracture of the distal humeral prosthesis (A). The damaged components of the prosthesis are extracted (B). Using 3D printing technology to design split‐piece sleeve prosthesis (C). The radiographs obtained during the 2‐year follow‐up demonstrated optimal prosthesis positioning without any evident signs of implant loosening, periprosthetic fracture, or breakage (D).

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