Accuracy analysis of three‐dimensional bone surface models of the forearm constructed from multidetector computed tomography data

Oka, Kunihiro; Murase, Tsuyoshi; Moritomo, Hisao; Gotō, Akira; Sugamoto, Kazuomi; Yoshikawa, Hideki

doi:10.1002/rcs.277

Cited by 92 publications

(61 citation statements)

References 46 publications

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“…However, regarding radiation exposure, our simulation system can produce 3-D bone models with low-dose radiation that is 30 of the normal radiation dose for the forearm [21]. We also plan to distribute our simulation system as commercial software in a few years.…”

Section: Discussionmentioning

confidence: 99%

Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation

Miyake

Murase

Moritomo

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Corrective osteotomy using dorsal plates and structural bone graft usually has been used for treating symptomatic distal radius malunions. However, the procedure is technically demanding and requires an extensive dorsal approach. Residual deformity is a relatively frequent complication of this technique. Questions/purposes We evaluated the clinical applicability of a three-dimensional osteotomy using computeraided design and manufacturing techniques with volar locking plates for distal radius malunions. Patients and Methods Ten patients with metaphyseal radius malunions were treated. Corrective osteotomy was simulated with the help of three-dimensional bone surface models created using CT data. We simulated the most appropriate screw holes in the deformed radius using computer-aided design data of a locking plate. During surgery, using a custom-made surgical template, we predrilled the screw holes as simulated. After osteotomy, plate fixation using predrilled screw holes enabled automatic reduction of the distal radial fragment. Autogenous iliac cancellous bone was grafted after plate fixation. Results The median volar tilt, radial inclination, and ulnar variance improved from À20°, 13°, and 6 mm, respectively, before surgery to 12°, 24°, and 1 mm, respectively, after surgery. The median wrist flexion improved from 33°b efore surgery to 60°after surgery. The median wrist extension was 70°before surgery and 65°after surgery. All patients experienced wrist pain before surgery, which disappeared or decreased after surgery. Conclusions Surgeons can operate precisely and easily using this advanced technique. It is a new treatment option for malunion of distal radius fractures.

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Section: Discussionmentioning

confidence: 99%

Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation

Miyake

Murase

Moritomo

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Apart from this, the resolution of the image data used for planning and the subsequent segmentation process are additional technical factors, which may also influence the planning accuracy. Nevertheless, bone models extracted from CT scans with an axial resolution of 1 mm and using interactive segmentation methods, such as thresholding and region growing, have been shown to be sufficiently accurate for preoperative planning [54]. Intraoperatively, the correct placement of the guide(s) on the bone also has a major impact on the accuracy of the entire procedure, because the reduction is computed relative to the osteotomy site.…”

Section: Resultsmentioning

confidence: 99%

Surgical Treatment of Long-Bone Deformities: 3D Preoperative Planning and Patient-Specific Instrumentation

Fürnstahl

Schweizer

Graf

et al. 2015

Lecture Notes in Computational Vision and Biomechanics

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Congenital or posttraumatic bone deformity may lead to reduced range of motion, joint instability, pain, and osteoarthritis. The conventional joint-preserving therapy for such deformities is corrective osteotomy-the anatomical reduction or realignment of bones with fixation. In this procedure, the bone is cut and its fragments are correctly realigned and stabilized with an implant to secure their position during bone healing. Corrective osteotomy is an elective procedure scheduled in advance, providing sufficient time for careful diagnosis and operation planning. Accordingly, computer-based methods have become very popular for its preoperative planning. These methods can improve precision not only by enabling the surgeon to quantify deformities and to simulate the intervention preoperatively in three dimensions, but also by generating a surgical plan of the required correction. However, generation of complex surgical plans is still a major challenge, requiring sophisticated techniques and profound clinical expertise. In addition to preoperative planning, computer-based approaches can also be used to support surgeons during the course of interventions. In particular, since recent advances in additive manufacturing technology have enabled cost-effective production of patient-and intervention-specific osteotomy instruments, customized interventions can thus be planned for and performed using such instruments. In this chapter, state of the art and future perspectives of computer-assisted deformity-correction surgery of the upper and lower extremities are presented. We elaborate on the benefits and pitfalls of different approaches based on our own experience in treating over 150 patients with three-dimensional preoperative planning and patient-specific instrumentation.

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“…Both forearms, from elbow to wrist, were scanned using CT using a low-dose technique (scan time, 0.5 seconds; slice thickness, 0.625 mm; 10 mA, 120 kV) [27] with a LightSpeed TM Ultra 16 CT scanner (General Electric, Waukesha, WI, USA) in three positions: maximum supination, neutral, and maximum pronation. Imaging was done with the patient in the prone position with the arms elevated above the head.…”

Section: Methodsmentioning

confidence: 99%

In Vivo Three-dimensional Motion Analysis of Chronic Radial Head Dislocations

Miyake

Moritomo

Kataoka

et al. 2012

Clinical Orthopaedics &Amp; Related Research

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Background Forearm kinematics and interosseous membrane function in chronic radial head dislocations sustained in childhood are unknown. Several procedures have been performed to reduce the radial head on the basis of static preoperative assessment in only one forearm position, but clinical results are not always favorable. Questions/purposes We investigated the in vivo threedimensional (3D) kinematics and length changes of interosseous membrane ligaments during forearm rotation in chronic radial head dislocations using 3D CT registration techniques. Methods We examined 10 patients with chronic radial head dislocations (seven Type 1 and three Type 4 Monteggia lesions). To quantify kinematics, the axis of rotation (AOR) and radial head motion were investigated using computer bone models constructed from CT data placing the forearm in three positions. We also created six interosseous membrane ligaments and calculated their 3D lengths during forearm rotation.

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Accuracy analysis of three‐dimensional bone surface models of the forearm constructed from multidetector computed tomography data

Abstract: 3D bone models constructed from low-radiation dose CT data demonstrated the same level of accuracy as those constructed from normal-radiation dose data. The present simulation system can produce 3D bone models with one-thirtieth of the normal radiation dose in the forearm.

Cited by 92 publications

References 46 publications

Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation

Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation

Surgical Treatment of Long-Bone Deformities: 3D Preoperative Planning and Patient-Specific Instrumentation

In Vivo Three-dimensional Motion Analysis of Chronic Radial Head Dislocations

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