Open AccessComputer-assisted 3D planned corrective osteotomies in eight malunited radius fractures
Author(s) -
Monique M. J. Walenkamp,
R.J. Keizer,
Johannes G. G. Dobbe,
Geert J. Streekstra,
J. Carel Goslings,
Peter Kloen,
Simon D. Strackee,
Niels W. L. Schep
Publication year - 2015
Publication title -
strategies in trauma and limb reconstruction/strategies in trauma and limb reconstruction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.5
H-Index - 24
eISSN - 1828-8936
pISSN - 1828-8928
DOI - 10.1007/s11751-015-0234-2
Subject(s) - malunion , medicine , osteotomy , radius , orthopedic surgery , surgery , orthodontics , nonunion , computer science , computer security
In corrective osteotomy of the radius, detailed preoperative planning is essential to optimising functional outcome. However, complex malunions are not completely addressed with conventional preoperative planning. Computer-assisted preoperative planning may optimise the results of corrective osteotomy of the radius. We analysed the pre- and postoperative radiological result of computer-assisted 3D planned corrective osteotomy in a series of patients with a malunited radius and assessed postoperative function. We included eight patients aged 13-64 who underwent a computer-assisted 3D planned corrective osteotomy of the radius for the treatment of a symptomatic radius malunion. We evaluated pre- and postoperative residual malpositioning on 3D reconstructions as expressed in six positioning parameters (three displacements along and three rotations about the axes of a 3D anatomical coordinate system) and assessed postoperative wrist range of motion. In this small case series, dorsopalmar tilt was significantly improved (p = 0.05). Ulnoradial shift, however, increased by the correction osteotomy (6 of 8 cases, 75 %). Postoperative 3D evaluation revealed improved positioning parameters for patients in axial rotational alignment (62.5 %), radial inclination (75 %), proximodistal shift (83 %) and volodorsal shift (88 %), although the cohort was not large enough to confirm this by statistical significance. All but one patient experienced improved range of motion (88 %). Computer-assisted 3D planning ameliorates alignment of radial malunions and improves functional results in patients with a symptomatic malunion of the radius. Further development is required to improve transfer of the planned position to the intra-operative bone. Level of evidence IV.