scholarly journals Patient-specific distal radius locking plate for fixation and accurate 3D positioning in corrective osteotomy

2014 ◽  
Vol 9 (3) ◽  
pp. 179-183 ◽  
Author(s):  
G. J. Streekstra ◽  
S. D. Strackee ◽  
J. G. G. Dobbe ◽  
J. C. Vroemen
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Corrective Osteotomy ◽  
Patient Specific ◽  
3D Positioning

Surgical Technique of Corrective Osteotomy for Malunited Distal Radius Fracture Using the Computer-Simulated Patient Matched Instrument

2016 ◽  
Vol 21 (02) ◽  
pp. 133-139 ◽  
Author(s):  
Tsuyoshi Murase
Keyword(s):  
Bone Graft ◽  
Distal Radius Fracture ◽  
Distal Radius ◽  
Locking Plate ◽  
Corrective Osteotomy ◽  
Extensor Tendon ◽  
Radius Fracture ◽  
Soft Tissue Release ◽  
Dorsal Plate ◽  
Volar Locking Plate

The conventional corrective osteotomy for malunited distal radius fracture that employs dorsal approach and insertion of a trapezoidal bone graft does not always lead to precise correction or result in a satisfactory surgical outcome. Corrective osteotomy using a volar locking plate has recently become an alternative technique. In addition, the use of patient-matched instrument (PMI) via computed tomography simulation has been developed and is expected to simplify surgical procedures and improve surgical precision. The use of PMI makes it possible to accurately position screw holes prior to the osteotomy and simultaneously perform the correction and place the volar locking plate once the osteotomy is completed. The bone graft does not necessarily require a precise block form, and the problem of the extensor tendon contacting the dorsal plate is avoided. Although PMI placement and soft tissue release technique require some degree of specialized skill, they comprise a very useful surgical procedure. On the other hand, because patients with osteoporosis are at risk of peri-implant fracture, tandem ulnar shortening surgery should be considered to avoid excessive lengthening of the radius.

Corrective osteotomy of distal radial deformities: a new method of guided locking fixed screw positioning

2011 ◽  
Vol 38 (1) ◽  
pp. 29-34 ◽  
Author(s):  
M. Farshad ◽  
F. Hess ◽  
L. Nagy ◽  
A. Schweizer
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Corrective Osteotomy ◽  
Standard Technique ◽  
New Method ◽  
New Technique ◽  
Clinical Use ◽  
Volar Locking Plate ◽  
New Device ◽  
Radial Inclination

Corrective osteotomy for distal radial malunion is a valuable but at times technically challenging operation. We have developed a new device to aid in the performance of the operation. We compared clinical use of the new technique with the standard technique. In 11 patients treated with the new technique the volar locking plate needed repositioning only once. With the standard technique in 17 patients the plate was repositioned in nine cases and needed bending in six cases. The new method corrected radial inclination (SD of 3° vs. 9°) and ulnar variance (SD of 0.9 mm vs. 1.4 mm) more predictably than the standard technique but there was no advantage in correction of volar tilt (SD of 6° vs. 4°). In our experience the new device makes corrective osteotomy of the distal radius easier and more reliable.

MALUNITED FRACTURES OF THE DISTAL RADIUS TREATED WITH CORRECTIVE OSTEOTOMY USING VOLAR LOCKING PLATE AND A CORTICOCANCELLOUS BONE GRAFT FOLLOWING IMMEDIATE MOBILISATION

Hand Surgery ◽  
2007 ◽  
Vol 12 (03) ◽  
pp. 183-190 ◽  
Author(s):  
Denju Osada ◽  
Shuzo Kamei ◽  
Morimitsu Takai ◽  
Kazuo Tomizawa ◽  
Kazuya Tamai
Keyword(s):  
Distal Radius ◽  
Bone Grafting ◽  
Locking Plate ◽  
Corrective Osteotomy ◽  
Treatment Method ◽  
Contralateral Side ◽  
Volar Locking Plate ◽  
Forearm Rotation ◽  
Volar Approach

We describe our experience of using a volar locking plate for corrective osteotomy and bone grafting combined with early mobilisation in the treatment of distal radius malunions. Corrective osteotomy of the distal radius was performed through a volar approach, and fixated by a volar locking plate associated with corticocancellous iliac bone grafting in three patients aged 16, 71 and 75 years. Two patients had had volarly displaced malunion and one dorsally displaced malunion. Wrist motin was started immediately after surgery. The average follow-up was 15 months (range, 12–20 months). All osteotomies healed at an average 5.7 weeks post-operatively, resulting in a total arc of wrist motion of 133°, forearm rotation of 167°, and grip strength of 70% of that of the contralateral side. This treatment method proved to be effective and safe.

scholarly journals Corrective Osteotomy for Deformity of the Distal Radius Using a Volar Locking Plate

Hand ◽  
2007 ◽  
Vol 3 (1) ◽  
pp. 61-68 ◽  
Author(s):  
Brett Peterson ◽  
Varun Gajendran ◽  
Robert M. Szabo
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Corrective Osteotomy ◽  
Volar Locking Plate

scholarly journals Volar Locking Plate Breakage after Nonunion of a Distal Radius Osteotomy

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Sergi Barrera-Ochoa ◽  
Sergi Rodríguez-Alabau ◽  
Andrea Sallent ◽  
Francisco Soldado ◽  
Xavier Mir
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Demineralized Bone Matrix ◽  
Plate Fixation ◽  
Corrective Osteotomy ◽  
Bone Matrix ◽  
Early Mobilization ◽  
Osteotomy Site ◽  
Volar Locking Plate ◽  
Plate Breakage

We report a 38-year-old male with a nonunion followed by plate breakage after volar plating of a distal radius osteotomy. Volar locking plates have added a new approach to the treatment of distal radius malunions, due to a lower morbidity of the surgical approach and the strength of the final construction, allowing early mobilization and return to function. Conclusion. Plate breakage is an uncommon complication of volar locking plate fixation. To our knowledge, few cases have been described after a distal radius fracture and no case has been described after a distal radius corrective osteotomy. In the present case, plate breakage appears to have occurred as a result of a combination of multiple factors as the large corrective lengthening osteotomy, the use of demineralized bone matrix instead of bone graft, and the inappropriate fixation technique as an unfilled screw on the osteotomy site, rather than the choice of plate.

scholarly journals A 3D printed cast for minimally invasive transfer of distal radius osteotomy: a cadaver study

2021 ◽  
Author(s):  
G. Caiti ◽  
J. G. G. Dobbe ◽  
S. D. Strackee ◽  
M. H. M. van Doesburg ◽  
G. J. Strijkers ◽  
...  
Keyword(s):  
Distal Radius ◽  
Corrective Osteotomy ◽  
Cadaver Study ◽  
Normal Weight ◽  
Patient Specific ◽  
Navigation Systems ◽  
Surgical Guides ◽  
Osteosynthesis Material ◽  
3D Printed ◽  
Guiding System

Abstract Purpose In corrective osteotomy of the distal radius, patient-specific 3D printed surgical guides or optical navigation systems are often used to navigate the surgical saw. The purpose of this cadaver study is to present and evaluate a novel cast-based guiding system to transfer the virtually planned corrective osteotomy of the distal radius. Methods We developed a cast-based guiding system composed of a cast featuring two drilling slots as well as an external cutting guide that was used to orient the surgical saw for osteotomy in the preoperatively planned position. The device was tested on five cadaver specimens with different body fat percentages. A repositioning experiment was performed to assess the precision of replacing an arm in the cast. Accuracy and precision of drilling and cutting using the proposed cast-based guiding system were evaluated using the same five cadaver arms. CT imaging was used to quantify the positioning errors in 3D. Results For normal-weight cadavers, the resulting total translation and rotation repositioning errors were ± 2 mm and ± 2°. Across the five performed surgeries, the median accuracy and Inter Quartile Ranges (IQR) of pre-operatively planned drilling trajectories were 4.3° (IQR = 2.4°) and 3.1 mm (IQR = 4.9 mm). Median rotational and translational errors in transferring the pre-operatively planned osteotomy plane were and 3.9° (IQR = 4.5°) and 2.6 mm (IQR = 4.2 mm), respectively. Conclusion For normal weight arm specimens, navigation of corrective osteotomy via a cast-based guide resulted in transfer errors comparable to those using invasive surgical guides. The promising positioning capabilities justify further investigating whether the method could ultimately be used in a clinical setting, which could especially be of interest when used with less invasive osteosynthesis material.

Corrective distal radius osteotomy following fracture malunion using a fixed-angle volar locking plate

2013 ◽  
Vol 39 (4) ◽  
pp. 431-435 ◽  
Author(s):  
S. Opel ◽  
S. Konan ◽  
E. Sorene
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Wrist Joint ◽  
Corrective Osteotomy ◽  
Volar Locking Plate ◽  
Short Term ◽  
Fixed Angle ◽  
Post Traumatic ◽  
Radiological Union

Post-traumatic distal radius deformity may cause severe morbidity, and corrective osteotomy is often necessary to realign the functional axis of the wrist to correct symptomatic malunion. The aim of this retrospective study was to review the short-term results of a single surgeon’s series of distal radius corrective osteotomies following fracture malunion using a fixed-angle volar locking plate for 20 patients (26 women) of an average age of 57 (range 19–83) years. At short-term follow up (average 14 months, range 12–15 months), no complications were noted and radiological union was confirmed in all cases at an average of 3 months. The average post-operative Disability of the Arm, Shoulder and Hand score was 13.48 (range 0–48.33) and an objective improvement was noted in movements at the wrist joint. A statistically significant improvement was achieved in ulnar variance, radial inclination, dorsal tilt, and supination.

scholarly journals Patient-specific plate for navigation and fixation of the distal radius: a case series

2021 ◽  
Author(s):  
Johannes G. G. Dobbe ◽  
Abbas Peymani ◽  
Hendrika A. L. Roos ◽  
Maikel Beerens ◽  
Geert J. Streekstra ◽  
...  
Keyword(s):  
Distal Radius ◽  
Imaging Techniques ◽  
Corrective Osteotomy ◽  
Case Series ◽  
Patient Specific ◽  
Alignment Error ◽  
Postoperative Results ◽  
Level Of Evidence ◽  
Radiographic Outcomes ◽  
2D Imaging

Abstract Purpose Corrective osteotomy of a malunited distal radius conventionally relies on 2D imaging techniques for alignment planning and evaluation. However, this approach results in suboptimal bone repositioning, which is associated with poor patient outcomes. In this case series, we evaluate the use of novel patient-specific plates (PSPs), which feature navigation and fixation of bone segments as preoperatively planned in 3D. Methods Ten participants with distal radius malunion underwent CT scans for preoperative alignment planning. Patient-specific guides and plates were designed, 3D-printed, and sterilized for use in corrective surgery of the distal radius. Pre- and postoperative results were compared in regard to clinical, functional, and radiographic outcomes. Results The application of a PSP was successful in 7 of the 10 cases. After treatment, the residual alignment error was reduced by approximately 50% compared with conventional treatment. The use of PSPs reduced pain significantly. Pre- and postoperative results were pooled and demonstrated significant correlations between: (1) pain and malpositioning, (2) the range of pro- and supination motion, the MHOQ score, the EQ-5D-5L score and dorsovolar angulation, and (3) MHOQ score and proximodistal translation. Conclusion The correlation between malalignment and MHOQ score, EQ-5D-5L score, pain, and range of motion shows that alignment should be restored as well as possible. Compared to the conventional approach, which relies on 2D imaging techniques, corrective osteotomy based on 3D preoperative planning and intraoperative fixation with a PSP has been shown to improve bone alignment and reduce pain. Level of evidence IV.

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