3D Printed Model Used as Preoperative Tool for Treating Acromioclavicular Joint Dislocation with Pre-Contoured Clavicle Hook Plate: Technical Note

Abstract

Objective To introduce a new technique using real-size 3D-printed acromioclavicular joint models as preoperative tools for treating acromioclavicular (AC) joint dislocation.

Methods Both the injured AC joint and the mirrored normal side AC joint are 3D printed into real-size models. A proper hook plate is selected and pre-bended to fit the normal side AC joint. The bended plate is then used to perform a reduction operation on a real-size injured AC joint model and the result is compared with the mirrored normal AC joint model to see if the reduction is accurate.

Results It is easy to select and bend a clavicle hook plate to achieve an accurate reduction with the help of a 3D printing technique.

Conclusion With this technique, surgeons can achieve an accurate reduction of the injured AC joint with a clavicle hook plate which might be helpful to reduce the risk of complications.

Zusammenfassung

Ziel Einführung einer neuen Technik unter Verwendung von 3D-gedruckten akromioklavierförmigen Gelenkmodellen in realer Größe als präoperative Werkzeuge zur Behandlung akromioklavikulärer (AC) Gelenkverrenkungen.

Methoden Sowohl das verletzte AC-Gelenk als auch das gespiegelte normale Seiten-AC-Gelenk werden in 3D-Formate gedruckt. Eine richtige Hakenplatte wird ausgewählt und vorgebogen, um die normale Seitenacac-Verbindung zu passen. Die gebogene Platte wird dann verwendet, um eine Reduktionsoperation auf einem realen verletzten AC-Gelenkmodell durchzuführen und das Ergebnis wird mit dem gespiegelten normalen AC-Gelenkmodell verglichen, um zu sehen, ob die Reduzierung korrekt ist.

Ergebnisse Es ist einfach, eine Schlüsselklappenplatte auszuwählen und zu biegen, um eine genaue Reduktion mit Hilfe einer 3D-Drucktechnik zu erreichen.

Fazit Mit dieser Technik können Chirurgen eine genaue Reduktion des verletzten AC-Gelenks mit einer Schlüsselbeinhakenplatte erreichen, die hilfreich sein könnte, um das Risiko von Komplikationen zu reduzieren.

Key words

acromioclavicular joint dislocation - clavicle hook plate - 3D printing

Schlüsselwörter

akromioklavikuläre Gelenkverrenkungen - Schlüsselklappenplatte - 3-D-Druck

^* Xuhua Wu and Gang Wang are co-first author; contributed equally

• References

• 1 Spencer jr. EE. Treatment of grade III acromioclavicular joint injuries: a systematic review. Clin Orthop Relat Res 2007; 455: 38-44
• 2 Li X, Ma R, Bedi A. et al. Management of acromioclavicular joint injuries. J Bone Joint Surg Am 2014; 96: 73-84
• 3 Stucken C, Cohen SB. Management of acromioclavicular joint injuries. Orthop Clin North Am 2015; 46: 57-66
• 4 Gowd AK, Liu JN, Cabarcas BC. et al. Current Concepts in the Operative Management of Acromioclavicular Dislocations: A Systematic Review and Meta-analysis of Operative Techniques. Am J Sports Med 2018; DOI: 10.1177/0363546518795147.
• 5 Di Francesco A, Zoccali C, Colafarina O. et al. The use of hook plate in type III and V acromio-clavicular Rockwood dislocations: clinical and radiological midterm results and MRI evaluation in 42 patients. Injury 2012; 43: 147-152
• 6 Chen CH, Dong QR, Zhou RK. et al. Effects of hook plate on shoulder function after treatment of acromioclavicular joint dislocation. Int J Clin Exp Med 2014; 7: 2564-2570
• 7 Ding M, Ni J, Hu J. et al. Rare complication of clavicular hook plate: clavicle fracture at the medial end of the plate. J Shoulder Elbow Surg 2011; 20: e18-e20
• 8 Charity RM, Haidar SG, Ghosh S. et al. Fixation failure of the clavicular hook plate: a report of three cases. J Orthop Surg (Hong Kong) 2006; 14: 333-335
• 9 Shih CM, Huang KC, Pan CC. et al. Biomechanical analysis of acromioclavicular joint dislocation treated with clavicle hook plates in different lengths. Int Orthop 2015; 39: 2239-2244
• 10 Yoon JP, Lee YS, Song GS. et al. Morphological analysis of acromion and hook plate for the fixation of acromioclavicular joint dislocation. Knee Surg Sports Traumatol Arthrosc 2017; 25: 980-986
• 11 ElMaraghy AW, Devereaux MW, Ravichandiran K. et al. Subacromial morphometric assessment of the clavicle hook plate. Injury 2010; 41: 613-619
• 12 Tiren D, van Bemmel AJ, Swank DJ. et al. Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview. J Orthop Surg Res 2012; 7: 2
• 13 Hung LK, Su KC, Lu WH. et al. Biomechanical analysis of clavicle hook plate implantation with different hook angles in the acromioclavicular joint. Int Orthop 2017; 41: 1663-1669
• 14 Lee CH, Shih CM, Huang KC. et al. Biomechanical analysis of implanted clavicle hook plates with different implant depths and materials in the acromioclavicular joint: a finite element analysis study. Artif Organs 2016; 40: 1062-1070
• 15 Deng Z, Cai L, Ping A. et al. Anatomical research on the subacromial interval following implantation of clavicle hook plates. Int J Sports Med 2014; 35: 857-862
• 16 Lin HY, Wong PK, Ho WP. et al. Clavicular hook plate may induce subacromial shoulder impingement and rotator cuff lesion-dynamic sonographic evaluation. J Orthop Surg Res 2014; 9: 6
• 17 Upex P, Jouffroy P, Riouallon G. Application of 3D printing for treating fractures of both columns of the acetabulum: benefit of pre-contouring plates on the mirrored healthy pelvis. Orthop Traumatol Surg Res 2017; 103: 331-334
• 18 Bibb R, Winder J. A review of the issues surrounding three-dimensional computed tomography for medical modelling using rapid prototyping techniques. Radiography 2010; 16: 78-83
• 19 Kunz M, Waldman SD, Rudan JF. et al. Computer-assisted mosaic arthroplasty using patient-specific instrument guides. Knee Surg Sports Traumatol Arthrosc 2012; 20: 857-861
• 20 Tetsworth K, Block S, Glatt V. Putting 3D modelling and 3D printing into practice: virtual surgery and preoperative planning to reconstruct complex post-traumatic skeletal deformities and defects. SICOT J 2017; 3: 16
• 21 Rengier F, Mehndiratta A, von Tengg-Kobligk H. et al. 3D printing based on imaging data: review of medical applications. Int J Comput Assist Radiol Surg 2010; 5: 335-341
• 22 Bagaria V, Deshpande S, Rasalkar DD. et al. Use of rapid prototyping and three-dimensional reconstruction modeling in the management of complex fractures. Eur J Radiol 2011; 80: 814-820
• 23 Bilici M, Thieringer F, Brantner P. et al. Rapid processing 3D printing for preoperative planing and precontouring of implants for acute acetabular fractures-a case series. Br J Surg 2017; 104: 17
• 24 Kim HN, Liu XN, Noh KC. Use of a real-size 3D-printed model as a preoperative and intraoperative tool for minimally invasive plating of comminuted midshaft clavicle fractures. J Orthop Surg Res 2015; 10: 91
• 25 Kim DS, Jeong HS, Park KJ. et al. A Comparison between Open Reduction/Internal Fixation and Minimally Invasive Plate Osteosynthesis Using a 3-Dimensional Printing Model for Displaced Clavicular Fractures. J Korean Orthop Assoc 2018; 53: 324-331