The usage of an individual plate for osteosynthesis at hip joint arthroplasty in a patient with a long-term transacetabular fracture with bone fragments displacement
Pelvic fractures are among the severe injuries of the musculoskeletal system, which are not always diagnosed in a timely manner, they are accompanied by a significant number of complications and adverse effects.
Objective: to inform the readers with the clinical case of total hip arthroplasty and pelvic osteosynthesis in a patient with transacetabular fracture with bone fragments displacement and post-traumatic hip joint arthritis.
Results: the patient had serious vehicle accident, fracture of the hip and anterior column was not diagnosed in time. After urgent care and stabilizing of the patient, she was discharged into outpatient treatment with severe pain syndrome. Hip joint X-rays were made in 3 months after injury. At preoperative planning we made X-rays of the pelvic and multispiral computed tomography. According to the results of the computed tomography, a plastic model of the pelvis was printed to assess the fracture and degree of displacement. A model was created and an individual implant of titanium powder for pelvic bone osteosynthesis was printed. Direction of screwing and their size are calculated individually. We made hip replacement and the osteosynthesis of the pelvic bones with the individual trabecular structured plate. Defects of the acetabular bottom are filled with autograft from the resected femoral head. In the postoperative period, the weight bearing on the operated limb was limited to the consolidation of the fracture and the restructuring of the bone material. 3 months later consolidation and function restoration were recorded.
Conclusions: computed tomography is necessarily in patients with pelvic fractures at preoperative examination. If necessary, additive technologies can be used to create spatial reconstruction of the damaged segment.
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