Intra-Articular Proximal Phalanx Osteotomy Using a Three-Dimensional Printed Template: A Case Report

Abstract

Malunion of an intra-articular fracture of the metacarpophalangeal joint can cause a dramatic effect, decreasing mobility and strength. For small joints, surgical options are often drastic; joint arthroplasty or arthrodesis. However, in cases of preserved joint space, an intra-articular osteotomy can be proposed. In order to improve preoperative planning, considering the small size of the articular surface and the importance of a precise osteotomy plane, we used a preoperative three-dimensional printed template to perform the intra-articular opening wedge osteotomy. This was followed by plate and screw osteosynthesis after adding a freeze-dried allograft to the created defect. The outcome at 1-year follow-up was more than satisfactory, with a normal range of motion and a restored, painless grip strength. A three-dimensional printed template is a useful, accurate, and efficient method to correct malunion of intra-articular fractures of the base of the proximal phalanx at the metacarpophalangeal joint.

Keywords

• corrective osteotomy
• intra-articular fracture
• malunion
• phalangeal osteotomy
• three-dimensional printing