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

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.

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Funding

No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

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Correspondence to Francesco Langella.

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Conflict of interest

We wish to draw the attention or the Editor to the following facts, which may be considered as potential conflicts of interest. Raffaele Russo, MD: he is a cofounder in an innovative start-up: Elisa srl. The Company is focused on R&D, consultancy and formation in the Orthopedic & Trauma fields. This author wish to confirm that there are conflicts of interest associated with this publication but there has been no financial support. Livia Renata Pietroluongo, MSc: she is a cofounder in an innovative start-up: Elisa srl. The Company is focused on R&D, consultancy and formation in the Orthopedic & Trauma fields. This author wish to confirm that there are conflicts of interest associated with this publication but there has been no financial support. Fabrizio Fiorentino, Bachelor: he is a cofounder in an innovative start-up: Elisa srl. The Company is focused on R&D, consultancy and formation in the Orthopedic & Trauma fields. This author wish to confirm that there are conflicts of interest associated with this publication but there has been no financial support. Antonio Guastafierro, MD: The author has no relevant financial or non-financial interests to disclose. Giuseppe della Rotonda, MD: The author has no relevant financial or non-financial interests to disclose. Stefano Viglione, MD: The author has no relevant financial or non-financial interests to disclose. Michele Ciccarelli, MD: The author has no relevant financial or non-financial interests to disclose. Paolo Minopoli, Bachelor: The author has no relevant financial or non-financial interests to disclose. Marco Mortellaro, MSc: The author has no relevant financial or non-financial interests to disclose. Francesco Langella, MD: The author has no relevant financial or non-financial interests to disclose. No benefits, funding or grants in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Informed consent

All patients gave informed consent prior to inclusion in the study, and all procedures were in accordance with the 1964 Declaration of HELSINKI and its later amendments.

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Russo, R., Guastafierro, A., Della Rotonda, G. et al. Osteochondral allograft transplantation for complex distal humeral fractures assisted by 3D computer planning and printing technology: technical note. Eur J Orthop Surg Traumatol (2021). https://doi.org/10.1007/s00590-021-03118-6

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Keywords

  • Distal humerus
  • Elbow
  • Complex fractures
  • Computer-assisted
  • 3D
  • Bone loss
  • Transplantation
  • Osteochondral allograft
  • Graft union
  • Frozen allograft