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Intra-Articular Corrective Osteotomy for Distal Radial Intra-Articular Malunion Using Patient-Matched Instruments: A
Kunihiro Oka1,2, Satoshi Miyamura1, Ryoya Shiode1
1Department of Orthopaedic Surgery, Graduate School of Medicine, Osaka University, Osaka, Japan.
JB & JS Open Access
|August 20, 2024
Summary
Patient-matched instruments significantly improved outcomes for distal radial intra-articular malunion. This corrective osteotomy technique reduced deformity and restored wrist function, demonstrating a high level of patient satisfaction.
Area of Science:
- Orthopedic surgery
- Surgical innovation
- Biomechanical engineering
Background:
- Intra-articular malunion of the distal radius presents a significant surgical challenge.
- Patient-matched instruments, developed through computer simulation, offer enhanced precision for intra-articular correction.
Purpose of the Study:
- To evaluate the efficacy of intra-articular corrective osteotomy using patient-matched instruments for distal radial intra-articular malunion.
- To assess the reduction of intra-articular deformity and restoration of wrist function at 12 months post-surgery.
Main Methods:
- A prospective study of 12 patients with distal radial intra-articular malunion.
- Utilized patient-matched instruments for corrective osteotomy with a primary endpoint of ≤1.5 mm articular step-off on CT scans.
- Secondary endpoints included range of motion, grip strength, pain (VAS), patient satisfaction, DASH, and PRWE scores.
Main Results:
- Significant improvement in average step-off from 3.75 mm preoperatively to 0.51 mm at 52-week follow-up, meeting the ≤1.5 mm target.
- Marked improvements observed in wrist/forearm range of motion, VAS pain scores, grip strength, DASH, and PRWE scores.
- High patient satisfaction reported, with 11 out of 12 patients expressing satisfaction or high satisfaction.
Conclusions:
- Patient-matched instruments are a valuable tool for improving postoperative outcomes in distal radius intra-articular corrective osteotomy.
- This technique effectively corrects intra-articular deformities and enhances functional recovery of the wrist.
