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Three-Dimensional Corrective Osteotomy for Malunited Diaphyseal Forearm Fractures Using Custom-Made Surgical Guides
Junichi Miyake1, Tsuyoshi Murase1, Kunihiro Oka2
1Departments of Orthopaedic Surgery (J.M., T.M., H.M., and H.Y.) and Orthopaedic Biomaterial Science (K.S.), Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita 565-0871, Osaka, Japan. E-mail address for J. Miyake: miyake-osk@umin.ac.jp. E-mail address for T. Murase: tmurase-osk@umin.ac.jp. E-mail address for H. Moritomo: moritomo@ort.med.osaka-u.ac.jp. E-mail address for H. Yoshikawa: yhideki@ort.med.osaka-u.ac.jp. E-mail address for K. Sugamoto: sugamoto@ort.med.osaka-u.ac.jp.
Introduction:
Three-dimensional corrective osteotomy with use of custom-made surgical guides based on computer simulation can provide a good outcome for patients with a malunited diaphyseal forearm fracture.
Step 1 Create Computer Bone Models From Ct Data:
Obtain CT data of both forearms, and create computer models of the bones from CT data.
Step 2 Evaluate 3d Deformity:
Evaluate the 3D deformity by comparing the affected bone with the mirror image of the contralateral, normal bone.
Step 3 Plan 3d Corrective Osteotomy:
Simulate the 3D corrective osteotomy on the basis of information obtained from the deformity evaluation.
Step 4 Design Custom-Made Surgical Guides:
Design custom-made surgical guides to reproduce the preoperative simulation during the actual surgery.
Step 5 Operative Setup:
Manufacture custom-made surgical guides to reproduce the preoperative simulation during the actual surgery.
Step 6 Perform 3d Osteotomy Using Custom-Made Osteotomy Guides:
Perform the osteotomy using the custom-made osteotomy guides and achieve anatomical correction using the reduction guides.
Results:
In our series of twenty patients, the average radiographic deformity angle preoperatively was 21° (range, 12° to 35°) compared with that of the normal arm; this improved to 1° (range, 0° to 4°) postoperatively.
What To Watch For:
IndicationsContraindicationsPitfalls & Challenges.
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