Опыт применения индивидуально изготовленного имплантата у пациента с повреждением тазового кольца

Rationale . The development of 3D printing technology allows the manufacture of individual implants to treat the patients with diseases and consequences of musculoskeletal system injuries. However, the use of additive technologies in the patients with multiple trauma in the acute period is limited. The purpose of study was to demonstrate the possibility of using individual implants for the definitive fixation of the anterior pelvic ring in a patient with multiple trauma. Patient concerns . A 22-year-old patient was admitted after an injury as a result of a fall from the 5 th floor. The treatment was carried out in accordance with the ATLS protocol. Diagnosis: multiple trauma; closed chest, pelvis and limbs injuries; fracture of the left 2nd to 5th ribs; pelvic bones fracture AO/ OTA: 61-C1.3a; fracture of both bones of the left lower leg AO/OTA: 42-B3b; 2nd degree shock. Interventions . An emergency external fixation of the pelvis and lower leg bones was performed. An individual implant for pubic bone fixation was made using 3D printing. On the 8th day, the definitive fixation of the pelvic and left lower leg bones was performed. The patient is activated on the 1st day after the surgery. Outcomes . The early postoperative period was uneventful. The functional result on the Majeed scale in 6 months by remote filling out the questionnaire was 84 points. Lessons. The custom-made implants make it possible the successful fixation of the anterior pelvic ring. The use of 3D printing technologies for the osteosynthesis of pelvic fractures is promising, although requires further study.