[Treatment of symptomatic pseudarthrosis following acromion fracture with a patient-specific implant customized on a 3D-printed scapula].

OBJECTIVE

Patient-specific osteosynthesis for pseudarthrosis of the acromion.

INDICATIONS: Symptomatic pseudarthrosis of the acromion at the level of a meta/mesacromion.

CONTRAINDICATIONS: Infection; patient noncompliance regarding postoperative treatment protocol.

SURGICAL TECHNIQUE: Preoperatively, a patient-specific three-dimensional model of the scapula is printed. A locking compression plate (LCP) is individually adapted to this model. Via a dorsal surgical approach over the scapular spine, the pseudarthrosis is refreshed and autologous cancellous bone from the iliac crest is embedded in the fracture zone. This is followed by fixed-angle osteosynthesis with the individualized plate. In addition, tension banding with tapes is performed to reduce the tensile and shear forces on the fracture caused by the muscle.

POSTOPERATIVE MANAGEMENT: Consistent wearing of a shoulder-arm brace for 6 weeks postoperatively, active-assisted increase in range of motion for an additional 3 weeks, then gradual increase in weight-bearing and initiation of daily activities without additional weights until 12 weeks postoperatively.

RESULTS

Treatment with the presented technique resulted in radiographic consolidation of the fracture and significant improvement in range of motion and pain at the 1‑year follow-up.