3D printing-assisted total hip arthroplasty and internal fixation for the treatment of fresh acetabular fracture and femoral head necrosis: A case report

Abstract

Rationale: Posterior wall comminuted fractures of the acetabulum are typically caused by high-energy trauma, and the complex anatomical structure of the acetabulum makes their treatment challenging. However, reports of the treatment of fresh acetabular fractures combined with femoral head necrosis are extremely rare. Patient concerns: A 57-year-old male, injured in a car accident, presented with right hip pain and limited mobility. At the age of 50, the patient was diagnosed with avascular necrosis of the right femoral head, experiencing right hip pain and a limp while walking, for which conservative treatment was initiated. Diagnosis: The patient was clinically diagnosed with fresh comminuted posterior wall acetabular fracture and late-stage femoral head necrosis. Interventions: We applied 3D printing technology and computer-assisted virtual surgical techniques for preoperative planning, simulated fracture reduction, and designed personalized bone plates and screws for fixation of the posterior wall of the acetabulum. A single-stage total hip arthroplasty was performed to treat femoral head necrosis. Outcomes: He began walking with the assistance of a walker 1 month after surgery, and at 6 months post-surgery, the acetabular posterior wall fracture had effectively healed, allowing the patient to return to work. Lessons: The application of 3D printing technology in acetabular internal fixation and total hip arthroplasty is helpful for fracture assessment, facilitates smooth surgery, promotes fracture reduction and healing, restores hip joint function, and ensures a high level of safety.