3D-assisted corrective osteotomies of the distal radius: a comparison of pre-contoured conventional implants versus patient-specific implants,European Journal of Trauma and Emergency Surgery

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3D-assisted corrective osteotomies of the distal radius: a comparison of pre-contoured conventional implants versus patient-specific implants
European Journal of Trauma and Emergency Surgery ( IF 1.9 ) Pub Date : 2024-01-23 , DOI: 10.1007/s00068-023-02415-5
Miriam G E Oldhoff _{1,

2} , Nick Assink _{1,

2} , Joep Kraeima _{2,

3} , Jean-Paul P M de Vries ₄ , Kaj Ten Duis ₁ , Anne M L Meesters _{1,

2} , Frank F A IJpma ₁

Affiliation

Purpose

There is a debate whether corrective osteotomies of the distal radius should be performed using a 3D work-up with pre-contoured conventional implants (i.e., of-the-shelf) or patient-specific implants (i.e., custom-made). This study aims to assess the postoperative accuracy of 3D-assisted correction osteotomy of the distal radius using either implant.

Methods

Twenty corrective osteotomies of the distal radius were planned using 3D technologies and performed on Thiel embalmed human cadavers. Our workflow consisted of virtual surgical planning and 3D printed guides for osteotomy and repositioning. Subsequently, left radii were fixated with patient-specific implants, and right radii were fixated with pre-contoured conventional implants. The accuracy of the corrections was assessed through measurement of rotation, dorsal and radial angulation and translations with postoperative CT scans in comparison to their preoperative virtual plan.

Results

Twenty corrective osteotomies were executed according to their plan. The median differences between the preoperative plan and postoperative results were 2.6° (IQR: 1.6–3.9°) for rotation, 1.4° (IQR: 0.6–2.9°) for dorsal angulation, 4.7° (IQR: 2.9–5.7°) for radial angulation, and 2.4 mm (IQR: 1.3–2.9 mm) for translation of the distal radius, thus sufficient for application in clinical practice. There was no significant difference in accuracy of correction when comparing pre-contoured conventional implants with patient-specific implants.

Conclusion

3D-assisted corrective osteotomy of the distal radius with either pre-contoured conventional implants or patient-specific implants results in accurate corrections. The choice of implant type should not solely depend on accuracy of the correction, but also be based on other considerations like the availability of resources and the preoperative assessment of implant fitting.

中文翻译：

3D 辅助桡骨远端矫正截骨术：预轮廓传统植入物与患者特定植入物的比较

目的

对于是否应该使用预先轮廓的常规植入物（即现成的）或患者特定植入物（即定制的）进行 3D 检查来进行远端桡骨的矫正截骨术，存在争议。本研究旨在评估使用任一植入物进行 3D 辅助桡骨远端截骨术的术后准确性。

方法

使用 3D 技术计划对远端桡骨进行 20 次矫正截骨手术，并在经过 Thiel 防腐处理的人类尸体上进行。我们的工作流程包括虚拟手术规划和用于截骨和重新定位的 3D 打印指南。随后，用患者专用植入物固定左侧桡骨，用预先轮廓的常规植入物固定右侧桡骨。通过术后 CT 扫描测量旋转、背侧和径向角度以及平移，并与术前虚拟计划进行比较，评估校正的准确性。

结果

按照他们的计划，进行了二十次矫正截骨手术。术前计划与术后结果之间的中位差异为旋转 2.6°（IQR：1.6–3.9°）、背侧成角 1.4°（IQR：0.6–2.9°）、桡骨 4.7°（IQR：2.9–5.7°）角度和 2.4 毫米（IQR：1.3-2.9 毫米）用于远端桡骨的平移，因此足以应用于临床实践。将预先轮廓的传统种植体与患者专用种植体进行比较时，矫正精度没有显着差异。