{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:56:29Z","timestamp":1776405389372,"version":"3.51.2"},"reference-count":28,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:p>Developmental dysplasia of the hip (DDH) associated with an acute proximal femoral fracture on the same side is uncommon, and performing a one-stage total hip arthroplasty (THA) with concurrent fracture stabilization in such cases poses significant technical challenges. We present a case involving a 57-year-old female with a long history of right-sided DDH who was involved in a vehicular accident, leading to acute pain in her right hip, shortening of the limb, and restricted movement. Imaging studies indicated Hartofilakidis type II DDH along with a comminuted intertrochanteric fracture of the proximal femur and a pseudoacetabulum. Utilizing thin-slice computed tomography, we created a customized three-dimensional (3D) printed model of the pelvis and proximal femur, which allowed for detailed preoperative planning. This included evaluating the acetabular bone quality, identifying the true center of the acetabulum, selecting the appropriate cup size and orientation, and strategizing the femoral osteotomy and fixation with plates and cables. A one-stage cementless THA was executed through a posterolateral approach, featuring a small hemispherical cup securely placed in the true acetabulum and a size-16 biological femoral stem anchored distally across the fracture site, followed by the application of a lateral plate and titanium cable to stabilize the proximal femoral fracture. The patient began ambulation with the assistance of a walker on postoperative day 1. At 2 months after surgery, the pain score had decreased to 1\/10 on the visual analog scale (VAS), and radiographic evaluation demonstrated ongoing fracture healing. By 3 months postoperatively, the patient was pain-free (VAS 0\/10), had achieved a Harris Hip Score of 92, and showed restoration of lower-limb length. Imaging confirmed fracture union and stable prosthesis positioning, and the patient had returned to work independently. This case suggests that individualized 3D printing-assisted preoperative planning may improve the feasibility and early safety of one-stage cementless total hip arthroplasty combined with internal fixation for adult DDH with an ipsilateral proximal femoral fracture, and may provide a useful reference for preoperative decision-making in similarly complex cases.<\/jats:p>","DOI":"10.3389\/fsurg.2026.1752462","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:20:20Z","timestamp":1776403220000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["3D printing technology-assisted total hip arthroplasty for acute proximal femoral fracture and Hartofilakidis type II developmental dysplasia of the hip: a case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Hang","family":"Wen","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Central Hospital Affiliated to Shenyang Medical College , , , China","place":["Shenyang, Liaoning"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Central Hospital Affiliated to Shenyang Medical College , , , China","place":["Shenyang, Liaoning"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Central Hospital Affiliated to Shenyang Medical College , , , China","place":["Shenyang, Liaoning"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Central Hospital Affiliated to Shenyang Medical College , , , China","place":["Shenyang, Liaoning"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"153","DOI":"10.3390\/medicina56040153","article-title":"Developmental dysplasia of the hip: a review of etiopathogenesis, Risk Factors, and Genetic Aspects","volume":"56","author":"Harsanyi","year":"2020","journal-title":"Medicina (Kaunas)"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00590-023-03635-6","article-title":"The outcomes of total hip arthroplasty in developmental dysplasia of hip versus osteoarthritis: a systematic review and meta-analysis","volume":"34","author":"Salman","year":"2024","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"B3","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1111\/os.12614","article-title":"Restoration of proximal femoral anatomy during total hip arthroplasty for high developmental dysplasia of the hip: an original technique","volume":"12","author":"Wu","year":"2020","journal-title":"Orthop Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"749","DOI":"10.1007\/s00264-021-05294-w","article-title":"Risk factors of dislocation after total hip arthroplasty in patients with developmental dysplasia of the hip","volume":"46","author":"Mortazavi","year":"2022","journal-title":"Int Orthop"},{"key":"B5","doi-asserted-by":"publisher","first-page":"86","DOI":"10.1186\/s40001-021-00556-0","article-title":"Management of proximal femur fractures in the elderly: current concepts and treatment options","volume":"26","author":"Fischer","year":"2021","journal-title":"Eur J Med Res"},{"key":"B6","doi-asserted-by":"publisher","first-page":"856","DOI":"10.1007\/s43465-020-00093-8","article-title":"3D Printing navigation template used in total hip arthroplasty for developmental dysplasia of the hip","volume":"54","author":"Yan","year":"2020","journal-title":"Indian J Orthop"},{"key":"B7","doi-asserted-by":"publisher","first-page":"119","DOI":"10.1111\/os.13183","article-title":"Restoring rotation center in total hip arthroplasty for developmental dysplasia of the hip with the assistance of three dimensional printing technology: a pilot study","volume":"14","author":"Zhang","year":"2022","journal-title":"Orthop Surg"},{"key":"B8","doi-asserted-by":"publisher","first-page":"42","DOI":"10.1186\/s12891-020-03865-3","article-title":"Patient-reported outcomes in young adults with osteonecrosis secondary to developmental dysplasia of the hip\u2014a longitudinal and cross-sectional evaluation","volume":"22","author":"Marks","year":"2021","journal-title":"BMC Musculoskelet Disord"},{"key":"B9","doi-asserted-by":"publisher","first-page":"942","DOI":"10.3390\/jpm13060942","article-title":"Current surgical techniques in the treatment of adult developmental dysplasia of the hip","volume":"13","author":"Dhaliwal","year":"2023","journal-title":"J Pers Med"},{"key":"B10","doi-asserted-by":"publisher","first-page":"820","DOI":"10.1007\/s11999-008-0131-9","article-title":"The morphologic variations of low and high hip dislocation","volume":"466","author":"Hartofilakidis","year":"2008","journal-title":"Clin Orthop Relat Res"},{"key":"B11","doi-asserted-by":"publisher","first-page":"S38","DOI":"10.1016\/j.arth.2017.02.024","article-title":"Challenges in total hip arthroplasty in the setting of developmental dysplasia of the hip","volume":"32","author":"Greber","year":"2017","journal-title":"J Arthroplasty"},{"key":"B12","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1111\/os.13688","article-title":"Extra-articular blocking technique to resolve severe acetabular bone defect in developmental dysplasia of the hip","volume":"15","author":"Xu","year":"2023","journal-title":"Orthop Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1016\/j.jor.2017.07.007","article-title":"Reliability of the acetabular reconstruction technique using autogenous bone graft from resected femoral head in hip dysplasia: influence of the change of hip joint center on clinical outcome","volume":"14","author":"Song","year":"2017","journal-title":"J Orthop"},{"key":"B14","doi-asserted-by":"publisher","first-page":"277","DOI":"10.1186\/s12891-022-05168-1","article-title":"Biomechanical effect of metal augment and bone graft on cup stability for acetabular reconstruction of total hip arthroplasty in hip dysplasia: a finite element analysis","volume":"23","author":"Wang","year":"2022","journal-title":"BMC Musculoskelet Disord"},{"key":"B15","doi-asserted-by":"publisher","first-page":"5987","DOI":"10.62347\/tuyg1784","article-title":"Clinical efficacy and prognostic analysis of autologous femoral head structural bone grafting combined with total hip arthroplasty for crowe type II\/III developmental dysplasia of the hip in adults","volume":"17","author":"Li","year":"2025","journal-title":"Am J Transl Res"},{"key":"B16","doi-asserted-by":"publisher","first-page":"2936","DOI":"10.1016\/j.arth.2021.03.040","article-title":"Midterm outcomes after reconstruction of superolateral acetabular defects using flying buttress porous tantalum augments during revision total hip arthroplasty","volume":"36","author":"Cassar-Gheiti","year":"2021","journal-title":"J Arthroplasty"},{"key":"B17","doi-asserted-by":"publisher","first-page":"1761","DOI":"10.1016\/j.arth.2016.01.052","article-title":"Medial protrusio technique in cementless total hip arthroplasty for developmental dysplasia of the hip: a prospective 6- to 9-year follow-up of 43 consecutive patients","volume":"31","author":"Zha","year":"2016","journal-title":"J Arthroplasty"},{"key":"B18","doi-asserted-by":"publisher","first-page":"148","DOI":"10.4055\/cios.2010.2.3.148","article-title":"Cotyloplasty in cementless total hip arthroplasty for an insufficient acetabulum","volume":"2","author":"Kim","year":"2010","journal-title":"Clin Orthop Surg"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1008","DOI":"10.1016\/j.medengphy.2015.08.003","article-title":"The effect of cup outer sizes on the contact mechanics and cement fixation of cemented total hip replacements","volume":"37","author":"Hua","year":"2015","journal-title":"Med Eng Phys"},{"key":"B20","doi-asserted-by":"publisher","first-page":"2904","DOI":"10.21037\/qims-21-803","article-title":"Three-dimensional morphological analysis of true acetabulum in crowe type IV hip dysplasia via standard-sized cup-simulated implantation","volume":"12","author":"Yang","year":"2022","journal-title":"Quant Imaging Med Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1245","DOI":"10.1111\/os.12756","article-title":"High hip center technique in total hip arthroplasty for crowe type II-III developmental dysplasia: results of midterm follow-up","volume":"12","author":"Shen","year":"2020","journal-title":"Orthop Surg"},{"key":"B22","doi-asserted-by":"publisher","first-page":"2057","DOI":"10.1007\/s00264-018-4154-x","article-title":"Does high hip centre affect dislocation after total hip arthroplasty for developmental dysplasia of the hip?","volume":"43","author":"Komiyama","year":"2019","journal-title":"Int Orthop"},{"key":"B23","doi-asserted-by":"publisher","first-page":"7940242","DOI":"10.1155\/2021\/7940242","article-title":"Preoperative planning using 3D printing technology in orthopedic surgery","volume":"2021","author":"Alemayehu","year":"2021","journal-title":"Biomed Res Int"},{"key":"B24","doi-asserted-by":"publisher","first-page":"e34113","DOI":"10.1097\/md.0000000000034113","article-title":"The role of 3-dimensional preoperative planning for primary total hip arthroplasty based on artificial intelligence technology to different surgeons: a retrospective cohort study","volume":"102","author":"Zhang","year":"2023","journal-title":"Medicine(Baltimore)"},{"key":"B25","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1186\/s10195-022-00650-x","article-title":"Which stem in total hip arthroplasty for developmental hip dysplasia? A comparative study using a 3D CT-based software for pre-operative surgical planning","volume":"23","author":"Castagnini","year":"2022","journal-title":"J Orthop Traumatol"},{"key":"B26","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1186\/s13018-025-05773-5","article-title":"Functional morphology of trabecular system in human proximal femur: a perspective from P45 sectional plastination and 3D reconstruction finite element analysis","volume":"20","author":"Shah","year":"2025","journal-title":"J Orthop Surg Res"},{"key":"B27","doi-asserted-by":"publisher","first-page":"1963","DOI":"10.1016\/j.arth.2015.05.033","article-title":"Application of rapid prototyping pelvic model for patients with DDH to facilitate arthroplasty planning: a pilot study","volume":"30","author":"Xu","year":"2015","journal-title":"J Arthroplasty"},{"key":"B28","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.2106\/jbjs.20.02169","article-title":"Enhanced recovery after primary total hip and knee arthroplasty: a systematic review","volume":"103","author":"Morrell","year":"2021","journal-title":"J Bone Joint Surg Am"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1752462\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T05:20:21Z","timestamp":1776403221000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2026.1752462\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,17]]},"references-count":28,"alternative-id":["10.3389\/fsurg.2026.1752462"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2026.1752462","relation":{},"ISSN":["2296-875X"],"issn-type":[{"value":"2296-875X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,17]]},"article-number":"1752462"}}