Computer-assisted 3D planned corrective osteotomies in eight malunited radius fractures.
In corrective osteotomy of the radius, detailed preoperative planning is essential to optimising functional outcome. However, complex malunions are not completely addressed with conventional preoperative planning. Computer-assisted preoperative planning may optimise the results of corrective osteotomy of the radius. We analysed the pre- and postoperative radiological result of computer-assisted 3D planned corrective osteotomy in a series of patients with a malunited radius and assessed postoperative function. We included eight patients aged 13-64 who underwent a computer-assisted 3D planned corrective osteotomy of the radius for the treatment of a symptomatic radius malunion. We evaluated pre- and postoperative residual malpositioning on 3D reconstructions as expressed in six positioning parameters (three displacements along and three rotations about the axes of a 3D anatomical coordinate system) and assessed postoperative wrist range of motion. In this small case series, dorsopalmar tilt was significantly improved (p = 0.05). Ulnoradial shift, however, increased by the correction osteotomy (6 of 8 cases, 75 %). Postoperative 3D evaluation revealed improved positioning parameters for patients in axial rotational alignment (62.5 %), radial inclination (75 %), proximodistal shift (83 %) and volodorsal shift (88 %), although the cohort was not large enough to confirm this by statistical significance. All but one patient experienced improved range of motion (88 %). Computer-assisted 3D planning ameliorates alignment of radial malunions and improves functional results in patients with a symptomatic malunion of the radius. Further development is required to improve transfer of the planned position to the intra-operative bone. Level of evidence IV.
Trauma Unit, Department of Surgery, Academic Medical Centre, University of Amsterdam, room G4-137, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
M M J
MM
Walenkamp
Trauma Unit, Department of Surgery, Academic Medical Centre, University of Amsterdam, room G4-137, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands. rjodemuinckkeizer@amc.nl.
R J O
http://orcid.org/0000-0001-7370-7785
RJ
de Muinck Keizer
Biomedical Engineering and Physics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
J G G
JG
Dobbe
Biomedical Engineering and Physics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.|Department of Radiology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
G J
GJ
Streekstra
Trauma Unit, Department of Surgery, Academic Medical Centre, University of Amsterdam, room G4-137, P.O. Box 22660, 1100 DD, Amsterdam, The Netherlands.
J C
JC
Goslings
Department of Orthopaedic Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
P
P
Kloen
Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
S D
SD
Strackee
Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
N W L
NW
Schep
3D; Corrective osteotomy; Malunion; Radius