Malunited lateral tibial plateau fracture managed by intra-articular osteotomy with help of 3D printing

Malunited lateral tibial plateau fracture managed by intra-articular osteotomy with help of 3D printing

Mudit Sharma

Malunion after lateral tibial plateau fractures often results in chronic subluxation, pseudo-instability, stiffness and early arthrosis. There are only a few treatment options reported in literature, intra-articular osteotomy being one of them. However, it is technically demanding as accurately deciding the osteotomy site is a big challenge for surgeons. We present a case of a 35-years-old male with malunited tibial plateau fracture managed by double intra-articular osteotomy and fixed with anatomically contoured raft-plate and bone grafting. The preoperative planning was done using a full scale femursubtracted 3D printed model of tibia and patient specific 3D printed jig for accurately defining osteotomy lines. CT DICOM files were used to create VRT images of tibia using Mimics and 3-Matic software. Osteotomy lines were planned on the VRT image of bone in the 3-Matic software and jig was created corresponding to the planned osteotomy lines. 3D bone model and patient specific jig were printed and osteotomy was simulated pre-operatively to achieve anatomical reduction of articular surface.

Keywords: 3D printing, Intra-articular osteotomy, malunited lateral tibial plateau