Corrective Osteotomy for Symptomatic Clavicle Malunion Using Patient-specific Osteotomy and Reduction Guides

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering

Background:

• Midshaft clavicular fractures are frequently treated nonoperatively, but malunion with shortening is common.
• Clavicle shortening can impair shoulder strength, kinematics, and scapular position, leading to functional deficits and pain.
• Complications of malunion include thoracic outlet syndrome and nerve compression.

Purpose of the Study:

• To present a novel technique for corrective osteotomy in symptomatic clavicular malunions.
• To improve the precision of osteotomy and reduction in complex clavicular malunions.
• To restore the anatomical shape and length of the clavicle.

Main Methods:

• Preoperative computer planning utilizing the healthy contralateral clavicle for reference.
• Design and utilization of 3D-printed patient-specific guides for osteotomy and reduction.
• Application of the technique in corrective osteotomy for clavicular malunion.

Main Results:

• The technique facilitates precise determination of the osteotomy plane.
• Patient-specific guides aid in restoring the anatomical shape and length of the clavicle.
• Potential for improved outcomes in correcting complex clavicular malunions.

Conclusions:

• Computer planning and 3D-printed guides offer a precise method for corrective osteotomy in clavicular malunion.
• This technique addresses challenges in restoring clavicle anatomy, especially in multifragmentary fractures.
• It holds promise for improving functional and cosmetic outcomes in patients with symptomatic clavicular malunions.