Journal article
Accuracy and Early Clinical Outcome of 3-Dimensional Planned and Guided Single-Cut Osteotomies of Malunited Forearm Bones.
- Roner S Orthopedic Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland. Electronic address: simon.roner@balgrist.ch.
- Vlachopoulos L Computer Assisted Research and Development Team, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
- Nagy L Orthopedic Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
- Schweizer A Orthopedic Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
- Fürnstahl P Computer Assisted Research and Development Team, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
- 2017-09-11
Published in:
- The Journal of hand surgery. - 2017
Single-cut osteotomy
accuracy of osteotomies
computer-assisted planning
forearm osteotomies
patient-specific guides
Adolescent
Adult
Female
Fracture Fixation
Fractures, Malunited
Hand Strength
Humans
Imaging, Three-Dimensional
Male
Middle Aged
Osteotomy
Radius Fractures
Range of Motion, Articular
Retrospective Studies
Surgery, Computer-Assisted
Treatment Outcome
Ulna Fractures
Wrist Joint
Young Adult
English
PURPOSE
To investigate the reduction accuracy of 3-dimensional planned single-cut osteotomies (SCOTs) of the forearm that were performed using patient-specific guides.
METHODS
A retrospective analysis of SCOTs performed between 2012 and 2014 was performed. Ten patients (age, 15-59 years) with 6 malunions of the ulna and 6 malunions of the radius were identified. The reduction accuracy was assessed by comparing the 3-dimensional preoperative plan of each osteotomy with the superimposed bone model extracted from postoperative computed tomography data. The difference was assessed by 3-dimensional angle and in all 6 degrees of freedom (3 translations, 3 rotations) with respect to an anatomical coordinate system. Wrist range of motion and grip strength was assessed after a mean of 16.7 months and compared with the preoperative measurements.
RESULTS
On average, the 12 SCOTs demonstrated excellent accuracy of the reduction with respect to rotation (ie, pronation/supination, 4.9°; flexion/extension, 1.7°; ulnar/radial angulation, 2.0°) and translation (ie, proximal/distal, 0.8 mm; radial/ulnar, 0.8 mm; dorsal/palmar, 0.8 mm). A mean residual 3-dimensional angle of 5.8° (SD, 3.6°) was measured after surgery. All 6 patients operated on for reasons of a reduced range of motion demonstrated improved symptoms and increased movement (from 20° to 80°). In the patients with unstable/painful distal radioulnar joint, 3 were totally free of complaints and 1 patient showed residual pain during sports.
CONCLUSIONS
A SCOT combined with patient-specific guides is an accurate and reliable technique to restore normal anatomy in multiplanar deformities of the forearm.
TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic IV.
To investigate the reduction accuracy of 3-dimensional planned single-cut osteotomies (SCOTs) of the forearm that were performed using patient-specific guides.
METHODS
A retrospective analysis of SCOTs performed between 2012 and 2014 was performed. Ten patients (age, 15-59 years) with 6 malunions of the ulna and 6 malunions of the radius were identified. The reduction accuracy was assessed by comparing the 3-dimensional preoperative plan of each osteotomy with the superimposed bone model extracted from postoperative computed tomography data. The difference was assessed by 3-dimensional angle and in all 6 degrees of freedom (3 translations, 3 rotations) with respect to an anatomical coordinate system. Wrist range of motion and grip strength was assessed after a mean of 16.7 months and compared with the preoperative measurements.
RESULTS
On average, the 12 SCOTs demonstrated excellent accuracy of the reduction with respect to rotation (ie, pronation/supination, 4.9°; flexion/extension, 1.7°; ulnar/radial angulation, 2.0°) and translation (ie, proximal/distal, 0.8 mm; radial/ulnar, 0.8 mm; dorsal/palmar, 0.8 mm). A mean residual 3-dimensional angle of 5.8° (SD, 3.6°) was measured after surgery. All 6 patients operated on for reasons of a reduced range of motion demonstrated improved symptoms and increased movement (from 20° to 80°). In the patients with unstable/painful distal radioulnar joint, 3 were totally free of complaints and 1 patient showed residual pain during sports.
CONCLUSIONS
A SCOT combined with patient-specific guides is an accurate and reliable technique to restore normal anatomy in multiplanar deformities of the forearm.
TYPE OF STUDY/LEVEL OF EVIDENCE
Therapeutic IV.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.jhsa.2017.07.002
- PMID 28888571
- Persistent URL
- https://sonar.ch/global/documents/47343
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