3D‑printed customized semi‑restrictive elbow prosthesis for severe pseudoarthritis following comminuted fractures of the distal humerus: A case report and review

Distal humeral fractures are infrequent occurrences in clinical practice and reports of nonunion following comminuted fractures of the distal humerus, particularly those resulting in pseudarthrosis formation and severe pseudoarthritis, are exceedingly rare. This report describes the utilization of a 3D‑printed customized semi‑restrictive elbow prosthesis as a treatment modality for severe pseudoarthritis following comminuted fractures of the distal humerus. A 51‑year‑old male presented to the orthopedic outpatient department with a history of left elbow joint pain and restricted movement persisting for >2 decades. Diagnostic imaging, including radiography and computed tomography (CT), revealed traumatic arthritis of the distal left humerus with pseudarthrosis formation. The treatment protocol involved comprehensive preoperative assessments, including electrocardiogram, chest CT, complete blood count, liver and kidney function tests, and coagulation profile. Following the completion of these evaluations, a total elbow joint replacement was performed using a 3D‑printed, customized semi‑restrictive elbow prosthesis, accompanied by muscle and ligament repair, within the orthopedics department. Postoperatively, the patient's left elbow wound exhibited satisfactory healing, with significant alleviation of pain and marked improvement in joint mobility. The patient was discharged on the 7th day after the operation and is required to have a follow‑up checkup every month. This case report underscores the efficacy of employing a 3D‑printed, customized semi‑restrictive elbow prosthesis in the management of severe arthritis secondary to comminuted fractures of the distal humerus, particularly in cases with pseudarthrosis formation. The approach facilitates precise joint reconstruction and promotes optimal growth of prosthesis, bone, ligaments and tendons, demonstrating favorable clinical outcomes in postoperative functional recovery.