Osteochondral allograft transplantation for complex distal humeral fractures assisted by 3D computer planning and printing technology: technical note

Eur J Orthop Surg Traumatol. 2022 Oct;32(7):1443-1450. doi: 10.1007/s00590-021-03118-6. Epub 2021 Sep 15.

Abstract

Purpose: The surgical treatment of comminuted distal humeral articular fractures (DHF) is challenging and is jeopardized by the high rate of complications. The study aims to describe the application of osteochondral allograft (OCA) transplantation for the treatment of complex DHF assisted with a 3D printed specific instrumentation.

Methods: Retrospective study. Inclusion criteria were the presence of an articular multi-fragmented DHF treated with frozen OCA. Clinical, self-reported and radiographic outcomes were collected every 6 months. CT were performed at 2 years FU.

Results: Four patients were included. At a mean follow-up of 37.3 months (24-49) MEPS, DASH and VAS were 90 (80-100), 11.8 (0-25) and 1 (0-3) points, respectively. Not significant complication or reoperation was recorded. Graft healing was observed in 3 cases. In all cases, we observed arthritic progression after 2 years of follow-up.

Conclusion: OCA transplantation can be considered a reliable and safe procedure in patients affected by a complex DHF.

Level of evidence: Level V. Technical Notes.

Keywords: 3D; Bone loss; Complex fractures; Computer-assisted; Distal humerus; Elbow; Frozen allograft; Graft union; Osteochondral allograft; Transplantation.

MeSH terms

  • Allografts
  • Computers
  • Follow-Up Studies
  • Humans
  • Humeral Fractures* / surgery
  • Intra-Articular Fractures* / diagnostic imaging
  • Intra-Articular Fractures* / surgery
  • Printing, Three-Dimensional
  • Retrospective Studies
  • Treatment Outcome