Three-Dimensional Corrective Osteotomy of Malunited Fractures of the Upper Extremity with Use of a Computer Simulation System

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

doi:10.2106/jbjs.g.01299

Cited by 224 publications

(233 citation statements)

References 37 publications

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“…The technique has been described in detail previously [17,18,20,22]. The affected and contralateral forearms of all patients were scanned using a CT scanner [1].…”

Section: Methodsmentioning

confidence: 99%

“…On the basis of the evaluation, corrective osteotomy was simulated on the computer (Fig. 1) [17,18]. The distal fragment usually had dorsal angulation, shortening, and pronation deformities, and approximately 50% of the cases showed a radial tilt on 3-D evaluation.…”

Section: Methodsmentioning

confidence: 99%

“…These findings may be attributed to the fact that malunion of distal radius fractures usually has a three-dimensional (3-D) deformity that sometimes is complex and extensive [1,12]. Two-dimensional evaluation using plain radiographs does not always provide accurate information [1,12,18].…”

Section: Introductionmentioning

confidence: 99%

“…We also developed an intraoperative guiding system using a custom-made surgical template that makes it possible to perform a 3-D osteotomy as simulated for the treatment of malunited forearm fractures, cubitus varus deformity, and malunited distal radius fractures [17,18,20,22].…”

Section: Introductionmentioning

confidence: 99%

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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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“…The technique has been described in detail previously [17,18,20,22]. The affected and contralateral forearms of all patients were scanned using a CT scanner [1].…”

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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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“…The exact rotational deformity can be defined and marked at the beginning of the repositioning, but flexion and extension deformities are still defined and corrected by the shape of the plate. In contrast, the method of Murase et al [16] incorporates preoperative information by the individual prefabrication of K-wire and cutting guides which are adapted to the surface of the bone. The positions of the guides are thus defined by the shape of the bone.…”

Section: Discussionmentioning

confidence: 99%

Complex Radius Shaft Malunion: Osteotomy with Computer-Assisted Planning

Schweizer

Fürnstahl

Harders

et al. 2010

Hand (New York, N,Y.)

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We report about two cases with a combined axial and angular malunion of the radius shaft with functional loss of pro-supination. For the preoperative planning, a computer simulation was developed that allows the quantification of the malunion by comparing the 3-d surface model of the impaired bone with the contralateral anatomy. The proximal parts of the left and right radii are superimposed, while the different positions of the distal parts are used to quantify the malunion. This task is performed fully automatically which reduces the overall planning time. The osteotomies were performed according to the results of the computer-aided planning. The first case showed 1 year postoperatively an increase of pronation from 40°to 70°at expense of supination from 95°to 90°. The patient was practically pain-free and reported functional improvement. The second case showed 6 months postoperatively an improvement of supination from 15°to 40°and of pronation from 50°to 60°. The computer-assisted operation planning facilitated the quantification of combined axial and angular malunions which were difficult to detect on plain radiographs.

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Association of Computer-Assisted Virtual Preoperative Planning With Postoperative Mortality and Complications in Older Patients With Intertrochanteric Hip Fracture

et al. 2020

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Key Points Question Is preoperative planning using computer-assisted virtual surgical technology associated with decreases in the risks of all-cause 90-day mortality and postoperative complications among older patients with intertrochanteric hip fractures? Findings In this cohort study of 1221 older patients with intertrochanteric hip fractures, the use of computer-assisted virtual preoperative planning among a propensity score–matched cohort was associated with a lower incidence of 90-day mortality and postoperative complications compared with the use of conventional preoperative planning. Meaning This study’s findings suggest that preoperative planning using computer-assisted virtual surgical technology for older patients with intertrochanteric hip fractures is associated with decreases in the risks of all-cause 90-day mortality and postoperative complications.

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Three-Dimensional Corrective Osteotomy of Malunited Fractures of the Upper Extremity with Use of a Computer Simulation System

Abstract: Corrective osteotomy for a malunited fracture of the upper extremity with use of computer simulation and a custom-designed osteotomy template can accurately correct the deformity and improve the clinical outcome.

Cited by 224 publications

References 37 publications

Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation

Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation

Complex Radius Shaft Malunion: Osteotomy with Computer-Assisted Planning

Association of Computer-Assisted Virtual Preoperative Planning With Postoperative Mortality and Complications in Older Patients With Intertrochanteric Hip Fracture

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