Fixation-Based Surgery: A New Technique for Distal Radius Osteotomy

Croitoru, H.; Ellis, Randy E.; Prihar, R.; Small, C.F.; Pichora, David R.

doi:10.3109/10929080109146002

Cited by 49 publications

(7 citation statements)

References 14 publications

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“…The accuracy and reproducibility of the surgical method with our patient-specific cutting guide and angled jig is superior to other experimental studies that used 3-D navigation-based correction osteotomy methods, such as reported by Croitoru et al [5] ( φ err ≤ 4.0°; SD ≤ 6.5°) and a more recent study by Westphal et al [22] who showed an overall residual rotation deviation of 4.50° using an expensive robotic-assisted bone fracture reduction method. A limited number of clinical studies that used computer-assisted 3-D planning for correction osteotomy have reported accuracy and reproducibility data.…”

Section: Discussionmentioning

confidence: 62%

Computer-assisted and patient-specific 3-D planning and evaluation of a single-cut rotational osteotomy for complex long-bone deformities

Dobbe

Pré

Kloen

et al. 2011

Med Biol Eng Comput

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Malunion after long bone fracture results in an incorrect position of the distal bone segment. This misalignment may lead to reduced function of the limb, early osteoarthritis and chronic pain. An established treatment option is a corrective osteotomy. For complex malunions, a single-cut rotational osteotomy is sometimes preferred in cases of angular deformity in three dimensions. However, planning and performing this type of osteotomy is relatively complex. This report describes a computer-assisted method for 3-D planning and realizing a single-cut rotational osteotomy with a patient-specific cutting guide for orienting the osteotomy and an angled jig for adjusting the rotation angle. The accuracy and reproducibility of the method is evaluated experimentally using plastic bones. In addition, complex rotational deformities are simulated by a computer to investigate the relation between deformity and correction parameters. The computed relation between deformity and correction parameters enables the surgeon to judge the feasibility of a single-cut rotational osteotomy. This appears possible for deformities combining axial misalignment with sufficient axial rotation. The proposed 3-D method of preoperative planning and transfer with a patient-specific cutting guide and angled jig renders the osteotomy procedure easily applicable, accurate, reproducible, and is a good alternative for complex and expensive navigation systems.

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Section: Discussionmentioning

confidence: 62%

Computer-assisted and patient-specific 3-D planning and evaluation of a single-cut rotational osteotomy for complex long-bone deformities

Dobbe

Pré

Kloen

et al. 2011

Med Biol Eng Comput

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“…All participants suffered from a symptomatic, malunited fracture of the distal radius. For 25 participants, the initial fracture type was not specified [16, 23, 28, 30]; the remaining fractures were extra-articular ( n = 28) or combined extra- and intra-articular ( n = 15) in nature. Initial treatment comprised plaster cast immobilization with or without closed reduction in 34 patients and open reduction and internal fixation in 7 patients.…”

Section: Resultsmentioning

confidence: 99%

“…Initial treatment comprised plaster cast immobilization with or without closed reduction in 34 patients and open reduction and internal fixation in 7 patients. Four studies did not report the initial treatment ( n = 27) [16, 22, 23, 28]. The mean time between injury and the corrective osteotomy was specified for 38 patients and was 30 months (SD 80, range 2–360).…”

Section: Resultsmentioning

confidence: 99%

“…Athwal et al [19] and Croitoru et al [28] used an optical tracking device to guide the position of drill and screws. Three studies performed the osteotomy by hand but relied on a custom-made wedge-shaped repositioning device that was interposed in the osteotomy gap either temporarily [23, 29] or permanently [16].…”

Section: Resultsmentioning

confidence: 99%

“…In its simplest form, virtual or physical 3D models aid the surgeon in understanding and visualizing the planned osteotomy plane [27]. Additionally, there is the possibility to guide the reposition with optical tracking devices [19, 28]. Another option is the use of synthetic templates that can be placed in the osteotomy gap, thereby restoring the original position of the distal radius [23, 29].…”

Section: Introductionmentioning

confidence: 99%

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Three-dimensional virtual planning of corrective osteotomies of distal radius malunions: a systematic review and meta-analysis

Keizer¹,

Lechner²,

Mulders³

et al. 2017

Strategies in Trauma and Limb Reconstruction

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The purpose of this study was to summarize and evaluate results of three-dimensional (3D-) planned corrective osteotomies of malunited distal radius fractures. 3D-planning techniques provide the possibility to address 3D-deformity that conventional planning methods might not address. We systematically searched PubMed, EMBASE and the Cochrane library for studies that performed a 3D-planned corrective osteotomy on patients with a malunited distal radius fracture. Fifteen studies with a total of 68 patients were included in the analysis. In 96% of cases, the preoperatively present palmar tilt, radial inclination and ulnar variance showed statistically significant improvement postoperatively with restoration to within 5° or 2 mm of their normal values. Mean flexion–extension, pro-supination and grip strength showed statistically significant improvement (p < 0.05). Complications were reported in 11 out of 68 patients (16%). With the current advances in 3D printing technology, 3D-planned corrective osteotomies seem a promising technique in the treatment of complex distal radius malunions. Level of evidence IV Systematic review of case series, Level IV.

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Kinematic Geometry of Osteotomies

Smith

Bryant

Ellis

2005

Lecture Notes in Computer Science

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This paper presents a novel method for defining an osteotomy that can be used to represent all types of osteotomy procedures. In essence, we model an osteotomy as a lower-pair mechanical joint to derive the kinematic geometry of the osteotomy. This method was implemented using a commercially available animation software suite in order to simulate a variety of osteotomy procedures. Two osteotomy procedures are presented for a femoral malunion in order to demonstrate the advantages of our kinematic model in developing optimal osteotomy plans. The benefits of this kinematic model include the ability to evaluate the effects of various kinds of osteotomy and the elimination of potentially errorprone radiographic assessment of deformities.

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Fixation-Based Surgery: A New Technique for Distal Radius Osteotomy

Cited by 49 publications

References 14 publications

Computer-assisted and patient-specific 3-D planning and evaluation of a single-cut rotational osteotomy for complex long-bone deformities

Computer-assisted and patient-specific 3-D planning and evaluation of a single-cut rotational osteotomy for complex long-bone deformities

Three-dimensional virtual planning of corrective osteotomies of distal radius malunions: a systematic review and meta-analysis

Kinematic Geometry of Osteotomies

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