Recent advances in the surgical treatment of malunions in hand and forearm using three-dimensional planning and patient-specific instruments

2020 ◽  
Vol 39 (5) ◽  
pp. 352-362
Author(s):  
S. Singh ◽  
O. Andronic ◽  
P. Kaiser ◽  
L. Jud ◽  
L. Nagy ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Three Dimensional ◽  
Patient Specific ◽  
Recent Advances ◽  
Patient Specific Instruments

scholarly journals Use of three-dimensional technology for complications of upper limb fracture treatment

2019 ◽  
Vol 4 (6) ◽  
pp. 302-312 ◽  
Author(s):  
Maartje Michielsen ◽  
Annemieke Van Haver ◽  
Matthias Vanhees ◽  
Roger van Riet ◽  
Frederik Verstreken
Keyword(s):  
Upper Limb ◽  
Three Dimensional ◽  
Computer Software ◽  
Operation Time ◽  
Cost Benefit ◽  
Added Value ◽  
Patient Specific ◽  
Technical Developments ◽  
Key Factor ◽  
Patient Specific Instruments

In malunion cases, restoration of anatomy is a key factor in obtaining a good functional outcome, but this can be technically very challenging. Three-dimensional printed bone models can further improve understanding of the malunion pattern. The use of three-dimensional (3D) computer planning, and the assembly of patient-specific instruments and implants, especially in complex deformities of the upper limb, allow accurate correction while reducing operation time, blood loss volume and radiation exposure during surgery. One of the major disadvantages of the 3D technique is the additional cost because it requires specific computer software, a dedicated clinical engineer, and a 3D printer. Further technical developments and clinical investigations are necessary to better define the added value and cost/benefit relationship of 3D in the treatment of complex fractures, non-unions, and malunions. Cite this article: EFORT Open Rev 2019;4 DOI: 10.1302/2058-5241.4.180074

Ankylosis and pseudoankylosis of the temporomandibular joint in 10 dogs (1993–2015)

2016 ◽  
Vol 29 (05) ◽  
pp. 409-415 ◽  
Author(s):  
Peter Strøm ◽  
Boaz Arzi ◽  
Derek Cissell ◽  
Frank Verstraete
Keyword(s):  
Surgical Treatment ◽  
Range Of Motion ◽  
Temporomandibular Joint ◽  
Three Dimensional ◽  
Case Series ◽  
Patient Specific ◽  
Three Dimensional Printing ◽  
Temporomandibular Joint Ankylosis ◽  
Dimensional Printing ◽  
Joint Ankylosis

SummaryObjective: To describe the clinical features and results of treatment of true ankylosis and pseudoankylosis of the temporomandibular joint in dogs.Methods: This study was a retrospective case series. Ten client-owned dogs that were presented for inability to open the mouth or a severely decreased range of motion of the temporomandibular joint were included. Information on the surgical procedures performed and the perioperative complications were documented. Three-dimensional printing of the skull was performed in four dogs.Results: Two dogs were diagnosed with temporomandibular joint ankylosis and seven dogs with pseudoankylosis. One dog had evidence of combined temporomandibular joint ankylosis and pseudoankylosis. Of the seven dogs with pseudoankylosis, six had an osseous fusion involving the zygomatic arch and mandible. Surgical treatment was performed in nine dogs and a revision surgery was needed in one dog. Follow-up ranged from five months to eight years (mean: 48.6 months). Eight out of nine dogs that were treated surgically regained the ability to open their mouth, but six dogs never regained a fully normal temporomandibular joint range of motion.Clinical significance: Temporomandibular joint ankylosis and pseudoankylosis are uncommon in the dog. Surgical treatment for temporomandibular joint ankylosis or pseudoankylosis in dogs is a successful option and carries a prognosis dependent on patient-specific abnormalities. Computed tomography complemented with three- dimensional printing is valuable for understanding the extent of abnormalities and for preoperative planning.Supplementary material for this paper is available online at http://dx.doi.org/10.3415/VCOT-15-11-0189.

scholarly journals Corrective Osteotomy of Upper Extremity Malunions Using Three-Dimensional Planning and Patient-Specific Surgical Guides: Recent Advances and Perspectives

2021 ◽  
Vol 8 ◽  
Author(s):  
Babak Saravi ◽  
Gernot Lang ◽  
Rebecca Steger ◽  
Andreas Vollmer ◽  
Jörn Zwingmann
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Therapeutic Approach ◽  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Current Evidence ◽  
Patient Specific ◽  
Computer Assisted ◽  
Surgical Guides ◽  
Recent Advances

Malunions of the upper extremity can result in severe functional problems and increase the risk of osteoarthritis. The surgical reconstruction of complex malunions can be technically challenging. Recent advances in computer-assisted orthopedic surgery provide an innovative solution for complex three-dimensional (3-D) reconstructions. This study aims to evaluate the clinical applicability of 3-D computer-assisted planning and surgery for upper extremity malunions. Hence, we provide a summary of evidence on this topic and highlight recent advances in this field. Further, we provide a practical implementation of this therapeutic approach based on three cases of malunited forearm fractures treated with corrective osteotomy using preoperative three-dimensional simulation and patient-specific surgical guides. All three cases, one female (56 years old) and two males (18 and 26 years old), had painful restrictions in range of motion (ROM) due to forearm malunions and took part in clinical and radiologic assessments. Postoperative evaluation of patient outcomes showed a substantial increase in range of motion, reduction of preoperatively reported pain, and an overall improvement of patients' satisfaction. The therapeutic approach used in these cases resulted in an excellent anatomical and functional reconstruction and was assessed as precise, safe, and reliable. Based on current evidence and our results, the 3-D preoperative planning technique could be the new gold standard in the treatment of complex upper extremity malunions in the future.

scholarly journals Correction of complex three-dimensional deformities at the proximal femur using indirect reduction with angle blade plate and patient-specific instruments: a technical note

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Lukas Jud ◽  
Lazaros Vlachopoulos ◽  
Karl Grob
Keyword(s):  
Proximal Femur ◽  
Three Dimensional ◽  
Orthopedic Procedures ◽  
Patient Specific ◽  
Indirect Reduction ◽  
Subvastus Approach ◽  
Blade Plate ◽  
Patient Specific Instruments ◽  
Angle Blade ◽  
Angle Blade Plate

Abstract Background Corrective osteotomies for complex proximal femoral deformities can be challenging; wherefore, subsidies in preoperative planning and during surgical procedures are considered helpful. Three-dimensional (3D) planning and patient-specific instruments (PSI) are already established in different orthopedic procedures. This study gives an overview on this technique at the proximal femur and proposes a new indirect reduction technique using an angle blade plate. Methods Using computed tomography (CT) data, 3D models are generated serving for the preoperative 3D planning. Different guides are used for registration of the planning to the intraoperative situation and to perform the desired osteotomies with the following reduction task. A new valuable tool to perform the correction is the use of a combined osteotomy and implant-positioning guide, with indirect deformity reduction over an angle blade plate. Results An overview of the advantages of 3D planning and the use of PSI in complex corrective osteotomies at the proximal femur is provided. Furthermore, a new technique with indirect deformity reduction over an angle blade plate is introduced. Conclusion Using 3D planning and PSI for complex corrective osteotomies at the proximal femur can be a useful tool in understanding the individual deformity and performing the aimed deformity reduction. The indirect reduction over the implant is a simple and valuable tool in achieving the desired correction, and concurrently, surgical exposure can be limited to a subvastus approach.

scholarly journals The use of three-dimensional printing technology in orthopaedic surgery

2017 ◽  
Vol 25 (1) ◽  
pp. 230949901668407 ◽  
Author(s):  
Tak Man Wong ◽  
Jimmy Jin ◽  
Tak Wing Lau ◽  
Christian Fang ◽  
Chun Hoi Yan ◽  
...  
Keyword(s):  
Orthopaedic Surgery ◽  
Surgical Planning ◽  
Three Dimensional ◽  
Physical Models ◽  
Advanced Technology ◽  
Patient Specific ◽  
Printing Technology ◽  
Three Dimensional Printing ◽  
Facial Surgery ◽  
Patient Specific Instruments

Three-dimensional (3-D) printing or additive manufacturing, an advanced technology that 3-D physical models are created, has been wildly applied in medical industries, including cardiothoracic surgery, cranio-maxillo-facial surgery and orthopaedic surgery. The physical models made by 3-D printing technology give surgeons a realistic impression of complex structures, allowing surgical planning and simulation before operations. In orthopaedic surgery, this technique is mainly applied in surgical planning especially revision and reconstructive surgeries, making patient-specific instruments or implants, and bone tissue engineering. This article reviews this technology and its application in orthopaedic surgery.

scholarly journals Tumor resection at the pelvis using three-dimensional planning and patient-specific instruments: a case series

2016 ◽  
Vol 14 (1) ◽  
Author(s):  
Thorsten Jentzsch ◽  
Lazaros Vlachopoulos ◽  
Philipp Fürnstahl ◽  
Daniel A. Müller ◽  
Bruno Fuchs
Keyword(s):  
Tumor Resection ◽  
Three Dimensional ◽  
Case Series ◽  
Patient Specific ◽  
Patient Specific Instruments

scholarly journals THE USE OF CAD/CAM TECHNOLOGY IN SURGICAL TREATMENT OF CONDYLAR HEAD FRACTURE

2019 ◽  
Vol 112 (4) ◽  
pp. 23-31
Author(s):  
Tetiana Pavlychuk ◽  
Denis Chernogorskyi ◽  
Yurii Chepurnyi ◽  
Andrii Kopchak
Keyword(s):  
Surgical Treatment ◽  
Maxillofacial Surgery ◽  
Three Dimensional ◽  
Mouth Opening ◽  
Surrounding Tissue ◽  
Patient Specific ◽  
Number Of Patients ◽  
Two Component ◽  
Cad Cam ◽  
Condylar Head

Management of the condylar head fractures is still one of the most controversial issues of the maxillofacial surgery. The aim of the present study was to increase the accuracy and quality of the surgical treatment of condylar head fracture with the use of navigation surgical guide and patient specific reinforcement two-component plate and individualized fixator with the use of CAD/CAM technology. In study was included 8  patient with 10 condylar head fractured. In 5 cases was used navigation guides, in 4 cases (the biomechanical unfavorable)  was used the patient specific two-component plate and only in one case we used  individualized patient specific plate. A CT scan was done immediately after the operation. The reduction of the fragments and the location of the screws, plate and fixator were checked on the same view in the preoperative and postoperative pictures on the computer. The relation between the screw and the cortical bones was clearly shown on CT, and the sizes of the bicortical screws were suitable with no injury to the articular cartilage or surrounding tissue. The three-dimensional objects showed that the screw was in the designated position and the condyle had been replaced and fixed in the normal position. The height of the ramus on the fractured side was restored immediately postoperatively. The malocclusion was corrected and the passive mouth opening of each patient was never less than 3 cm. One  patients had transient paralysis of the temporal branch of the facial nerve postoperatively, which gradually recovered within a 2 month. Postoperative clinical examination showed good occlusion and mouth opening of at least 3 cm in all patients after 3 months without pain. All patients regained normal mandibular movements and had short and invisible scars at 6 months’ follow-up. Given the small number of patients, this issue needs further study in randomized prospective studies involving more patients and evaluating long-term postoperative outcomes

scholarly journals Numerical computation of blood flow for a patient-specific hemodialysis shunt model

2021 ◽  
Author(s):  
Surabhi Rathore ◽  
Tomoki Uda ◽  
Viet Q. H. Huynh ◽  
Hiroshi Suito ◽  
Toshitaka Watanabe ◽  
...  
Keyword(s):  
Stokes Equations ◽  
Three Dimensional ◽  
Arteriovenous Shunt ◽  
Navier Stokes ◽  
Patient Specific ◽  
Stabilized Finite Element ◽  
Computed Tomography Scanning ◽  
Outflow Boundary ◽  
Stage Renal Disease ◽  
End Stage

AbstractHemodialysis procedure is usually advisable for end-stage renal disease patients. This study is aimed at computational investigation of hemodynamical characteristics in three-dimensional arteriovenous shunt for hemodialysis, for which computed tomography scanning and phase-contrast magnetic resonance imaging are used. Several hemodynamical characteristics are presented and discussed depending on the patient-specific morphology and flow conditions including regurgitating flow from the distal artery caused by the construction of the arteriovenous shunt. A simple backflow prevention technique at an outflow boundary is presented, with stabilized finite element approaches for incompressible Navier–Stokes equations.

scholarly journals Application of subject-specific adaptive mechanical loading for bone healing in a mouse tail vertebral defect

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Angad Malhotra ◽  
Matthias Walle ◽  
Graeme R. Paul ◽  
Gisela A. Kuhn ◽  
Ralph Müller
Keyword(s):  
Mechanical Loading ◽  
Bone Defect ◽  
Bone Healing ◽  
Three Dimensional ◽  
Patient Specific ◽  
Dependent Manner ◽  
Micro Computed Tomography ◽  
Computed Tomography Images ◽  
Bone Defect Healing ◽  
Subject Specific

AbstractMethods to repair bone defects arising from trauma, resection, or disease, continue to be sought after. Cyclic mechanical loading is well established to influence bone (re)modelling activity, in which bone formation and resorption are correlated to micro-scale strain. Based on this, the application of mechanical stimulation across a bone defect could improve healing. However, if ignoring the mechanical integrity of defected bone, loading regimes have a high potential to either cause damage or be ineffective. This study explores real-time finite element (rtFE) methods that use three-dimensional structural analyses from micro-computed tomography images to estimate effective peak cyclic loads in a subject-specific and time-dependent manner. It demonstrates the concept in a cyclically loaded mouse caudal vertebral bone defect model. Using rtFE analysis combined with adaptive mechanical loading, mouse bone healing was significantly improved over non-loaded controls, with no incidence of vertebral fractures. Such rtFE-driven adaptive loading regimes demonstrated here could be relevant to clinical bone defect healing scenarios, where mechanical loading can become patient-specific and more efficacious. This is achieved by accounting for initial bone defect conditions and spatio-temporal healing, both being factors that are always unique to the patient.

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