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Case Report Open Access

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

  • Authors:
    • Bo Zheng
    • Xiu-Li Zhang
    • Yu-Xiang Cheng
    • Ze-Bi He
    • Peng Li
  • View Affiliations / Copyright

    Affiliations: Department of Orthopaedic Surgery, Chengdu Qingbaijiang District People's Hospital, Chengdu, Sichuan 610300, P.R. China, Department of Orthopaedic Surgery, Chengdu Qingbaijiang District People's Hospital, Chengdu, Sichuan 610300, P.R. China
    Copyright: © Zheng et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 159
    |
    Published online on: April 9, 2026
       https://doi.org/10.3892/etm.2026.13154
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Abstract

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.
View Figures

Figure 1

(A) Preoperative X-ray oblique view
image; (B) preoperative X-ray lateral view image; (C) preoperative
CT 3D oblique view image; (D) preoperative CT 3D anteroposterior
view image. (E) Preoperative elbow extension was limited to -25˚;
(F) Preoperative active elbow flexion range was 25-90˚.

Figure 2

The design process and surgical
procedure for the 3D-printed prosthesis. Panels (A-G) illustrate
the customization of the prosthesis, tailored to the patient's
specific size and modulus requirements; (A) Preoperative 3D CT
images; (B) 3D reconstruction images by simulation software; (C)
the calculated osteotomy length by simulation software; (D) 3D
printing prosthesis design plan by simulation software; (E)
detailed 3D prosthesis design with specific specifications by
simulation software; (F) lateral and anteroposterior images of the
3D printing prosthesis designed by simulation software; (G)
post-installation morphology images of the 3D printed prosthesis
designed by simulation software. Panels (H and I) depict the
physical manifestation of the 3D-printed custom prosthesis. Panel
(J) shows that during the operation, the elbow joint's shape was
obscured, resulting in the formation of a pseudo-joint. Panels (K
and L) present the morphology following osteotomy during the
operation and the morphology post-implantation of the prosthesis.
Panels (M and N) demonstrate the optimal positioning of the
3D-printed custom prosthesis as observed through intraoperative
fluoroscopy.

Figure 3

The patient's range of motion at 6
months after the operation. (A) Flexion (125˚) and (B) extension
(0˚).

Figure 4

(A) Day 1 anteroposterior X-ray; (B)
day 1 lateral X-ray; (C) 6-month anteroposterior X-ray; (D) 6-month
lateral X-ray. The arrows indicate the integration status of the
prosthesis with the bone interface.
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Copy and paste a formatted citation
Spandidos Publications style
Zheng B, Zhang X, Cheng Y, He Z and Li P: 3D‑printed customized semi‑restrictive elbow prosthesis for severe pseudoarthritis following comminuted fractures of the distal humerus: A case report and review. Exp Ther Med 31: 159, 2026.
APA
Zheng, B., Zhang, X., Cheng, Y., He, Z., & Li, P. (2026). 3D‑printed customized semi‑restrictive elbow prosthesis for severe pseudoarthritis following comminuted fractures of the distal humerus: A case report and review. Experimental and Therapeutic Medicine, 31, 159. https://doi.org/10.3892/etm.2026.13154
MLA
Zheng, B., Zhang, X., Cheng, Y., He, Z., Li, P."3D‑printed customized semi‑restrictive elbow prosthesis for severe pseudoarthritis following comminuted fractures of the distal humerus: A case report and review". Experimental and Therapeutic Medicine 31.6 (2026): 159.
Chicago
Zheng, B., Zhang, X., Cheng, Y., He, Z., Li, P."3D‑printed customized semi‑restrictive elbow prosthesis for severe pseudoarthritis following comminuted fractures of the distal humerus: A case report and review". Experimental and Therapeutic Medicine 31, no. 6 (2026): 159. https://doi.org/10.3892/etm.2026.13154
Copy and paste a formatted citation
x
Spandidos Publications style
Zheng B, Zhang X, Cheng Y, He Z and Li P: 3D‑printed customized semi‑restrictive elbow prosthesis for severe pseudoarthritis following comminuted fractures of the distal humerus: A case report and review. Exp Ther Med 31: 159, 2026.
APA
Zheng, B., Zhang, X., Cheng, Y., He, Z., & Li, P. (2026). 3D‑printed customized semi‑restrictive elbow prosthesis for severe pseudoarthritis following comminuted fractures of the distal humerus: A case report and review. Experimental and Therapeutic Medicine, 31, 159. https://doi.org/10.3892/etm.2026.13154
MLA
Zheng, B., Zhang, X., Cheng, Y., He, Z., Li, P."3D‑printed customized semi‑restrictive elbow prosthesis for severe pseudoarthritis following comminuted fractures of the distal humerus: A case report and review". Experimental and Therapeutic Medicine 31.6 (2026): 159.
Chicago
Zheng, B., Zhang, X., Cheng, Y., He, Z., Li, P."3D‑printed customized semi‑restrictive elbow prosthesis for severe pseudoarthritis following comminuted fractures of the distal humerus: A case report and review". Experimental and Therapeutic Medicine 31, no. 6 (2026): 159. https://doi.org/10.3892/etm.2026.13154
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