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Structural balance restoration in complex forearm problems using 3D technology.

Andreas Schweizer1, Maxim D Horwitz2, Angela E Kedgley3

  • 1Hand Surgery Department,University Hospital Balgrist, Switzerland.

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|March 31, 2026
PubMed
Summary
This summary is machine-generated.

Forearm reconstruction requires more than just anatomical correction. Integrating 3D planning, biomechanics, and soft tissue considerations is key to restoring forearm function and stability.

Keywords:
Balancedistal radioulnar jointforearmforearm biomechanicskinematicsligament stabilizationosteotomypronation–supinationthree-dimensional analysisthree-dimensional planning

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Area of Science:

  • Orthopedic surgery
  • Biomechanical engineering
  • Medical imaging

Background:

  • Forearm anatomy and function rely on the radius and ulna's interdependence.
  • Trauma or deformities disrupt forearm stability, mobility, and load transfer, causing pain and functional loss.
  • Advances in 3D imaging and printing enable precise analysis and correction of forearm deformities.

Purpose of the Study:

  • To present a comprehensive surgeon-engineer approach for forearm reconstruction.
  • To highlight the importance of integrating kinematic analysis, ligamentous tension, and joint congruity.
  • To address complex forearm deformities and their functional restoration.

Main Methods:

  • Utilizing 3D analysis with mirrored anatomy or statistical shape models.
  • Employing virtual osteotomy planning (single-cut, Z-osteotomies, parallel shortening).
  • Integrating kinematic analysis for impingement prediction and ligament tension modeling (interosseous membrane, triangular fibrocartilage complex).

Main Results:

  • Virtual planning allows for precise osteotomies and stable fixation.
  • Kinematic and tension modeling help prevent residual issues and optimize joint function.
  • Consideration of elbow, wrist, and forearm alignment is crucial, especially in complex cases.

Conclusions:

  • Forearm reconstruction necessitates a biomechanically informed strategy beyond anatomical correction.
  • Individualized 3D planning and patient-specific instrumentation are essential.
  • Soft tissue considerations are vital for re-establishing forearm equilibrium and function.