Innovative management of hypertrophic tibia and fibula nonunions: Outcomes of custom 3D-printed implants

Abstract

The presentation of a hypertrophic nonunion of the ankle after repeated failed surgeries presents a unique set of challenges that necessitate extensive surgical planning and preparation. Three-dimensional (3D) printing technology enables the creation of patient-specific surgical implants, offering tailored solutions for complex cases such as hypertrophic nonunion following repeated surgical failures. We present two cases that used customized 3D implantation devices to treat hypertrophic nonunion after a history of repeated failed surgical interventions. One patient underwent surgical correction of the distal tibial metaphysis nonunion and another patient underwent surgical correction of a distal fibula nonunion. After 3 years of follow-up, both patients demonstrated radiographic evidence of complete bone union, an 90 % reduction in pain Visual Analog Scale (VAS), restoration of functional mobility, 85 % improvement of AOFAS Ankle-Hindfoot scale, and corrected anatomic limb alignment. The use of patient-specific 3D implant devices in the case of hypertrophic nonunion is a successful integration of innovative technology in medicine. The technology of customizable implantation devices is a valuable tool in the surgical treatment of pathologies of the foot and ankle.