Application of three-dimensional prototyping in planning the treatment of proximal humerus bone deformities()

OBJECTIVE: To describe the use of three-dimensional prototyping or rapid prototyping in acrylic resin to create synthetic three-dimensional models in order to promote the understanding of bone deformities of the shoulder. METHODS: Five patients were analyzed between ages of 11 and 73 years old, treated between 2008 and 2013 with glenohumeral deformities that required a more thorough review of the anatomical alterations, for whom three-dimensional prototyping was performed. RESULTS: Patient 1 was treated conservatively and is awaiting humeral head arthroplasty if symptoms get worse. Patient 2 underwent a valgus proximal humerus osteotomy secured with pediatric locked hip plate according to a prior assessment with prototyping. Patient 3 underwent a disinsertion of the rotator cuff, tubercleplasty and posterior reinsertion of the rotator cuff. Patient 4 underwent an arthroscopic step-off resection, 360-degree capsulotomy, and tenolysis of the subscapularis. Patient 5 underwent a reverse shoulder arthroplasty with an L-shaped bone graft on the posterior glenoid. CONCLUSIONS: Rapid prototyping in acrylic resin allows a better preoperative planning in treatment of bone deformities in the shoulder, minimizing the risk of intraoperative complications in an attempt to improve the results.