Correction of severe wrist deformity following physeal arrest of the distal radius with the aid of a three-dimensional computer simulation.
Growth arrest following physeal injury may result in severe limb deformity. We report a case of complex wrist deformity caused by injury to the distal radial physis resulting in radial shortening and abnormal inclination of the radial articular surface, which was successfully treated by gradual correction after computer simulation. The simulation enabled us to develop an appropriate operative plan by accurately calculating the axis of the three-dimensional (3D) deformity using computer bone models. In the simulative surgery with a full-size stereolithography bone model, an Ilizarov external fixator was applied to the radius such that its two hinges were located on the virtual axis of the deformity, which was reproduced in the actual surgery. This technique of 3D computer simulation is a useful alternative to plan accurate correction of complex limb deformities following growth arrest.
Murase
Tsuyoshi
T
Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka, Japan. tmurase-osk@umin.ac.jp
Oka
Kunihiro
K
Moritomo
Hisao
H
Goto
Akira
A
Sugamoto
Kazuomi
K
Yoshikawa
Hideki
H
D002648:Child; D003198:Computer Simulation; D005542:Forearm / Q000000981:diagnostic imaging / Q000254:growth & development; D006801:Humans; D018889:Ilizarov Technique / Q000295:instrumentation*; D021621:Imaging, Three-Dimensional; D008297:Male; D010027:Osteotomy; D011885:Radius Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery*; D016059:Range of Motion, Articular; D000072042:Salter-Harris Fractures; D014057:Tomography, X-Ray Computed; D014953:Wrist / Q000000981:diagnostic imaging / Q000254:growth & development*