Patient-specific plates for distal radius osteotomy: a review of the literature and a parametric plate design concept

Distal radius fractures are the most common fractures in the body. While the majority heal well, some cases result in symptomatic malunion requiring surgical correction via osteotomy. Virtual surgical planning and patient-specific surgical guides are now widely used to improve precision over traditional two-dimensional planning and freehand osteotomy. However, these procedures almost exclusively use off-the-shelf plates that may not fit a patient's anatomy well. 3D-designed patient-specific plates (PSPs) provide a precise fit, overcoming the limitations of off-the-shelf plates.

We summarized the literature on PSPs for correcting distal radius malunion available in May 2025 using PubMed, and reference and citation screening. We discussed the outcomes, design considerations, and cost. We further proposed a parametric plate design concept. Lastly, we discussed design requirements and regulatory aspects of PSPs.

PSPs eliminate the need to compromise the virtual surgical plan to match the off-the-shelf plate, leading to more accurate and stable corrections. The parametric approach offers a more cost-effective alternative to designing PSPs, but further research is needed. Successful integration of parametric PSPs into clinical routine will require investments from plate manufacturers. Future studies will likely compare outcomes with off-the-shelf plates and PSPs in patients and 3D-printed bone models.