Computer-Assisted Corrective Osteotomy for Malunited Diaphyseal Forearm Fractures

Miyake, Junichi; Murase, Tsuyoshi; Oka, Kunihiro; Moritomo, Hisao; Sugamoto, Kazuomi; Yoshikawa, Hideki

doi:10.2106/jbjs.k.00829

Cited by 94 publications

(81 citation statements)

References 31 publications

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“…To reproduce preoperative simulation in the actual surgery, we developed an operative method that uses a custom-made osteotomy and reduction guides designed on the basis of a preoperative 3D computer simulation 13,18,19,22,28,34 and manufactured with medical-grade plastic materials by rapid prototype technology.…”

Section: Image Acquisition and Preoperative Simulationmentioning

confidence: 99%

“…9,10,15,30,38 Since 2003, we have been developing an original computer program that employs 3D imaging to simulate anatomic correction of the upper limb deformity based on computed tomography (CT) data. 18,19,22,34 In this system, we used a custom-made osteotomy and reduction guide to reproduce preoperative simulation in the actual surgical treatment of cubitus varus deformities, malunited distal radial fractures, and forearm fractures. 18,19,22 Internal fixation of the osteotomy site was performed with Kirschner wires or bone plates while the correction was being temporarily maintained.…”

mentioning

confidence: 99%

“…18,19,22,34 In this system, we used a custom-made osteotomy and reduction guide to reproduce preoperative simulation in the actual surgical treatment of cubitus varus deformities, malunited distal radial fractures, and forearm fractures. 18,19,22 Internal fixation of the osteotomy site was performed with Kirschner wires or bone plates while the correction was being temporarily maintained.…”

mentioning

confidence: 99%

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Postoperative accuracy analysis of three-dimensional corrective osteotomy for cubitus varus deformity with a custom-made surgical guide based on computer simulation

Omori

Murase

Oka

et al. 2015

Journal of Shoulder and Elbow Surgery

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Section: Image Acquisition and Preoperative Simulationmentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Postoperative accuracy analysis of three-dimensional corrective osteotomy for cubitus varus deformity with a custom-made surgical guide based on computer simulation

Omori

Murase

Oka

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…Note that the intra-articular fragments of the preoperative plan (brown) were virtually fused to make the registration more robust (Color figure online) accuracy of 1°/1 mm was reported for distal radius osteotomies performed with a similar technique. Several other studies have evaluated the feasibility and accuracy in a clinical setting for the forearm bones [29][30][31], the humerus [52], and the lower extremities [34]. In these studies, an average deviation from the 3D preoperative plan between 1°and 5°was measured after surgery, but the evaluation was only performed on postoperative radiographs.…”

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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“…We evaluated the bilateral symmetry of the clavicle by assessing the side-to-side differences with computer methods known from 3D surgical planning (Murase et al, 2008;Miyake et al, 2012;Kataoka et al, 2013) of mal-united bones, In these approaches, the 3D model of the pathological bone is separated into two parts defined by the location of the fracture. Each part is superimposed with the mirror-model of the contralateral bone (i.e., the reconstruction template) in an automatic fashion by applying a registration method for surface models, the so-called iterative closest point (Zhang and Chen, 2001) (ICP) algorithm.…”

Section: Methodsmentioning

confidence: 99%

Three‐dimensional corrective osteotomies of mal‐united clavicles—is the contralateral anatomy a reliable template for reconstruction?

et al. 2015

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In computer-assisted preoperative planning of corrective osteotomies, the unaffected contralateral bone often serves as three-dimensional template for the reconstruction of mal-united bones. Before applying this approach to new anatomy such as the clavicle bone, it is important to study asymmetry between the sides. The purpose of this study was to investigate bilateral symmetry of the clavicle in healthy cadavers using three-dimensional measurement techniques. Bilateral symmetry of 102 clavicles (51 cadavers, mean age: 52.19 years, 37 male) was measured based on three-dimensional models reconstructed from computed tomography. Besides length, volume, and surface, the side-differences were evaluated by considering the mirrored left clavicle as the reconstruction template and the right clavicle as the one that will be realigned by osteotomy. The relative transformation between the aligned segments was measured to express the difference with to three-dimensional translation and rotation. The same procedure was repeated using mean-sized clavicles, one for each gender, as the template. The contralateral side was a significant more accurate reconstruction template compared to a mean-sized clavicle (P < 0.001). Nevertheless, an average side-differences with respect to rotation and translation of 8.79° ± 5.2° and 3.5 mm ± 2.7 mm, respectively. The left clavicles were significant (P = 0.001) longer with 154 mm compared to the right ones (151 mm). Three-dimensional differences between the left and right clavicles exist, but can be considered as small. Therefore, the contralateral side appears to be a reliable reconstruction template, in particular compared to a mean-sized clavicle.

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Computer-Assisted Corrective Osteotomy for Malunited Diaphyseal Forearm Fractures

Abstract: Computer-assisted osteotomy can provide excellent radiographic and clinical outcome for the treatment of malunited diaphyseal forearm fractures. Satisfactory restoration of forearm motion can be achieved even in relatively long-standing cases in adults.

Cited by 94 publications

References 31 publications

Postoperative accuracy analysis of three-dimensional corrective osteotomy for cubitus varus deformity with a custom-made surgical guide based on computer simulation

Postoperative accuracy analysis of three-dimensional corrective osteotomy for cubitus varus deformity with a custom-made surgical guide based on computer simulation

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

Three‐dimensional corrective osteotomies of mal‐united clavicles—is the contralateral anatomy a reliable template for reconstruction?

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