Qiuju Miao1, Huanwen Ding2, Minqiang Huang1, Jianjian Shen3, Qiang Tu3, Miaojun Huang4. 1. Department of Bone and Joint Disease, Guangzhou General Hospital of Guangzhou Military, Guangzhou Guangdong, 510010, P.R.China;Graduate College, Traditional Chinese Medicine University of Guangzhou, Guangzhou Guangdong, 510010, P.R.China. 2. Department of Bone and Joint Disease, Guangzhou General Hospital of Guangzhou Military, Guangzhou Guangdong, 510010, P.R.China.dhuanwen123@aliyun.com. 3. Department of Bone and Joint Disease, Guangzhou General Hospital of Guangzhou Military, Guangzhou Guangdong, 510010, P.R.China. 4. Guangdong University of Technology, Guangzhou Guangdong, 510006, P.R.China.
Abstract
Objective: To explore the clinical methods of resection of elbow tumor and total elbow replacement with custom personalized prosthesis based on three dimensional (3-D) printing navigation template. Methods: In August 2016, a 63-year-old male patient with left elbow joint tumor was treated, with the discovery of the left distal humerus huge mass over 3 months, with elbow pain, activity limitation of admission. Computer-assisted reduction technique combined with 3-D printing was used to simulate preoperative tumor resection, a customized personal prosthesis was developed; tumor was accurately excised during operation, and the clinical result was evaluated after operation. Results: The time was 46 minutes for tumor resection, and was 95 minutes for personalized implant and allograft bone without fluoroscopy. X-ray and CT examination at 1 week after operation showed good position of artificial elbow joint; the anteversion of ulna prosthesis was 30° and the elbow carrying angle was 15°, which were consistent with the simulated results before surgery. The finger flexion was normal at 1 month after operation; the range of motion was 0-130° for elbow flexion and extension, 80° for forearm pronation, and 80° for forearm supination. The elbow function was able to meet the needs of daily life at 7 months after operation, and no recurrence and metastasis of tumor were observed. Conclusion: For limb salvage of elbow joint, computer aided design can make preoperative surgical simulation; the navigation template can improve surgical precision; and the function of elbow joint can be reconstructed with customized and personlized prosthesis for total elbow replacement.
Objective: To explore the clinical methods of resection of elbow tumor and total elbow replacement with custom personalized prosthesis based on three dimensional (3-D) printing navigation template. Methods: In August 2016, a 63-year-old male patient with left elbow joint tumor was treated, with the discovery of the left distal humerus huge mass over 3 months, with elbow pain, activity limitation of admission. Computer-assisted reduction technique combined with 3-D printing was used to simulate preoperative tumor resection, a customized personal prosthesis was developed; tumor was accurately excised during operation, and the clinical result was evaluated after operation. Results: The time was 46 minutes for tumor resection, and was 95 minutes for personalized implant and allograft bone without fluoroscopy. X-ray and CT examination at 1 week after operation showed good position of artificial elbow joint; the anteversion of ulna prosthesis was 30° and the elbow carrying angle was 15°, which were consistent with the simulated results before surgery. The finger flexion was normal at 1 month after operation; the range of motion was 0-130° for elbow flexion and extension, 80° for forearm pronation, and 80° for forearm supination. The elbow function was able to meet the needs of daily life at 7 months after operation, and no recurrence and metastasis of tumor were observed. Conclusion: For limb salvage of elbow joint, computer aided design can make preoperative surgical simulation; the navigation template can improve surgical precision; and the function of elbow joint can be reconstructed with customized and personlized prosthesis for total elbow replacement.
Entities:
Keywords:
Total elbow replacement; bone tumor; computer aided design; elbow prosthesis; three-dimensional printing technology