PMC7476707_01
Pre-operative radiographs.
JOCR-10-25-g001.jpg
PMC7476707_01_JOCR-10-25-g001.jpg
F1
At 4-month follow-up, the left side fracture has united but on the right side, there was non-union with collapse of head and penetration of screw (Figure 1).
After implant removal with associated glenoid fracture (a) radiograph (b) axial image of computed tomography scan.
JOCR-10-25-g002.jpg
PMC7476707_01_JOCR-10-25-g002.jpg
F2
Due to the fracture, the procedure was abandoned, and we decided to treat the glenoid fracture conservatively with immobilization (Figure 2).
Computed tomographyimages after glenoid fracture union.
JOCR-10-25-g003.jpg
PMC7476707_01_JOCR-10-25-g003.jpg
F3
After 4 months, a CT scan with 3D reconstruction of the right shoulder was done and glenoid fracture union was confirmed(Figure 3).
(a and b) 3D glenoid bone models on which mock surgery was done.
JOCR-10-25-g004.jpg
PMC7476707_01_JOCR-10-25-g004.jpg
F4
Mock surgery was done with the 3D printed jig on the 3D printed glenoid to assess the accuracy of position, direction, and depth of the central peg(Figure 4).
Intraoperative use of custom-made jigs and glenoid bone model.
JOCR-10-25-g005.jpg
PMC7476707_01_JOCR-10-25-g005.jpg
F5
The custom-made jigs were ETO (Ethylene Oxide) sterilized and used intraoperatively for making the central hole in the glenoid to find a good position and direction of central peg to accommodate a good length of the 6.5mm central screw (Figure 5).
Post-operative radiographs.
JOCR-10-25-g006.jpg
PMC7476707_01_JOCR-10-25-g006.jpg
F6
The remaining part of surgery went uneventful (Figure 6).
Axial computed tomography images showing the length of (a) central screw and (b), (c) peripheral screws inside the bone.
JOCR-10-25-g007.jpg
PMC7476707_01_JOCR-10-25-g007.jpg
F7
It is found that 2.27 cm length of the central screw (Figure 7a), and 1.57 cm and 1.59 cm length of the two peripheral screws(Figure 7b, 7c) were inside the glenoid vault and are in the exact position as desired.
Clinical image of the patient demonstrating forward elevation of 110  and lateral elevation of 90 .
JOCR-10-25-g008.jpg
PMC7476707_01_JOCR-10-25-g008.jpg
F8
On regular follow-up, the patient has a stable shoulder with active forward elevation of 110 , lateral elevation of 90 , and an external rotation of 10  at 1-year follow-up (Figure 8).