Purpose
To investigate the reduction accuracy of 3-dimensional planned single-cut osteotomies
(SCOTs) of the forearm that were performed using patient-specific guides.
Methods
A retrospective analysis of SCOTs performed between 2012 and 2014 was performed. Ten
patients (age, 15–59 years) with 6 malunions of the ulna and 6 malunions of the radius
were identified. The reduction accuracy was assessed by comparing the 3-dimensional
preoperative plan of each osteotomy with the superimposed bone model extracted from
postoperative computed tomography data. The difference was assessed by 3-dimensional
angle and in all 6 degrees of freedom (3 translations, 3 rotations) with respect to
an anatomical coordinate system. Wrist range of motion and grip strength was assessed
after a mean of 16.7 months and compared with the preoperative measurements.
Results
On average, the 12 SCOTs demonstrated excellent accuracy of the reduction with respect
to rotation (ie, pronation/supination, 4.9°; flexion/extension, 1.7°; ulnar/radial
angulation, 2.0°) and translation (ie, proximal/distal, 0.8 mm; radial/ulnar, 0.8
mm; dorsal/palmar, 0.8 mm). A mean residual 3-dimensional angle of 5.8° (SD, 3.6°)
was measured after surgery. All 6 patients operated on for reasons of a reduced range
of motion demonstrated improved symptoms and increased movement (from 20° to 80°).
In the patients with unstable/painful distal radioulnar joint, 3 were totally free
of complaints and 1 patient showed residual pain during sports.
Conclusions
A SCOT combined with patient-specific guides is an accurate and reliable technique
to restore normal anatomy in multiplanar deformities of the forearm.
Type of study/level of evidence
Therapeutic IV.
Key words
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Article info
Publication history
Published online: September 06, 2017
Accepted:
July 3,
2017
Received:
May 18,
2016
Footnotes
L.N., A.S., and P.F. are shareholders of Computer Assisted Surgical Planning Application, Balgrist CARD AG, Zurich, Switzerland.
Identification
Copyright
© 2017 by the American Society for Surgery of the Hand. All rights reserved.
