Corrective Osteotomies in Malunions of the Distal Radius, Using Preoperative 3-Dimensional Computer Planning and Patient-Specific Surgical Guides

Malunions of the distal radius are often treated with correction osteotomies, which can be challenging to perform.In this report, 23 patients with symptomatic distal radius malunions were treated using 3D printed patient-specific surgical guides to facilitate surgery. Patients were compared with a control group of 23 patients that underwent similar surgery with a conventional x-ray planning approach.Postoperatively all patients in the computer-assisted group showed recovery of ROM, with no anatomical abnormalities on x-ray examination. 6 patients in the conventional planning group had reduced ROM with a residual volar tilt on x-ray images.Computer-assisted planning with the use of 3D printed patient-specific surgical guides enhances results of corrective osteotomies of distal radius malunions.

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Corrective Osteotomy for Malunited Diaphyseal Forearm Fractures Using Preoperative 3-Dimensional Planning and Patient-Specific Surgical Guides and Implants

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2017.06.003 ◽

2017 ◽

Vol 42 (10) ◽

pp. 836.e1-836.e12 ◽

Cited By ~ 12

Author(s):

Ann-Maria Byrne ◽

Bianca Impelmans ◽

Veronique Bertrand ◽

Annemieke Van Haver ◽

Frederik Verstreken

Keyword(s):

Corrective Osteotomy ◽

Patient Specific ◽

Forearm Fractures ◽

3 Dimensional ◽

Surgical Guides

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

International Journal of Computer Assisted Radiology and Surgery ◽

10.1007/s11548-021-02310-7 ◽

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.

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Three-Dimensional Correction of Distal Radius Intra-Articular Malunions Using Patient-Specific Drill Guides

The Journal Of Hand Surgery ◽

10.1016/j.jhsa.2013.09.023 ◽

2013 ◽

Vol 38 (12) ◽

pp. 2339-2347 ◽

Cited By ~ 74

Author(s):

Andreas Schweizer ◽

Philipp Fürnstahl ◽

Ladislav Nagy

Keyword(s):

Distal Radius ◽

Three Dimensional ◽

Patient Specific

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Variation in femoral anteversion in patients requiring total hip replacement

Hip International ◽

10.1177/1120700019848088 ◽

2019 ◽

Vol 30 (3) ◽

pp. 281-287

Author(s):

Jim W Pierrepont ◽

Ed Marel ◽

Jonathan V Baré ◽

Leonard R Walter ◽

Catherine Z Stambouzou ◽

...

Keyword(s):

Total Hip Replacement ◽

Hip Replacement ◽

Femoral Stem ◽

Femoral Anteversion ◽

Patient Specific ◽

3 Dimensional ◽

Total Hip ◽

Age Related ◽

Gender And Age ◽

Implant Alignment

Background: Optimal implant alignment is important for total hip replacement (THR) longevity. Femoral stem anteversion is influenced by the native femoral anteversion. Knowing a patient’s femoral morphology is therefore important when planning optimal THR alignment. We investigated variation in femoral anteversion across a patient population requiring THR. Methods: Preoperatively, native femoral neck anteversion was measured from 3-dimensional CT reconstructions in 1215 patients. Results: The median femoral anteversion was 14.4° (−27.1–54.5°, IQR 7.4–20.9°). There were significant gender differences (males 12.7°, females 16.0°; p < 0.0001). Femoral anteversion in males decreased significantly with increasing age. 14% of patients had extreme anteversion (<0° or >30°). Conclusions: This is the largest series investigating native femoral anteversion in a THR population. Patient variation was large and was similar to published findings of a non-THR population. Gender and age-related differences were observed. Native femoral anteversion is patient-specific and should be considered when planning THR.

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Computer aided surgery planning and patient specific surgical guides

Türk Ortopedi ve Travmatoloji Birliği Derneği ◽

10.5578/totbid.dergisi.2022.09 ◽

2022 ◽

Vol 21 (1) ◽

pp. 46-55

Author(s):

Halil Can Gemalmaz

Keyword(s):

Patient Specific ◽

Computer Aided Surgery ◽

Surgery Planning ◽

Surgical Guides ◽

Computer Aided

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On-Demand Intraoperative 3-Dimensional Printing of Custom Cranioplastic Prostheses

Operative Neurosurgery ◽

10.1093/ons/opx280 ◽

2018 ◽

Vol 15 (3) ◽

pp. 341-349 ◽

Cited By ~ 3

Author(s):

Alexander I Evins ◽

John Dutton ◽

Sayem S Imam ◽

Amal O Dadi ◽

Tao Xu ◽

...

Keyword(s):

3D Printing ◽

Perioperative Complications ◽

Ease Of Use ◽

Patient Specific ◽

Production Time ◽

3 Dimensional ◽

3D Print ◽

Fused Deposition ◽

On Demand ◽

Dimensional Printing

Abstract BACKGROUND Currently, implantation of patient-specific cranial prostheses requires reoperation after a period for design and formulation by a third-party manufacturer. Recently, 3-dimensional (3D) printing via fused deposition modeling has demonstrated increased ease of use, rapid production time, and significantly reduced costs, enabling expanded potential for surgical application. Three-dimensional printing may allow neurosurgeons to remove bone, perform a rapid intraoperative scan of the opening, and 3D print custom cranioplastic prostheses during the remainder of the procedure. OBJECTIVE To evaluate the feasibility of using a commercially available 3D printer to develop and produce on-demand intraoperative patient-specific cranioplastic prostheses in real time and assess the associated costs, fabrication time, and technical difficulty. METHODS Five different craniectomies were each fashioned on 3 cadaveric specimens (6 sides) to sample regions with varying topography, size, thickness, curvature, and complexity. Computed tomography-based cranioplastic implants were designed, formulated, and implanted. Accuracy of development and fabrication, as well as implantation ability and fit, integration with exiting fixation devices, and incorporation of integrated seamless fixation plates were qualitatively evaluated. RESULTS All cranioprostheses were successfully designed and printed. Average time for design, from importation of scan data to initiation of printing, was 14.6 min and average print time for all cranioprostheses was 108.6 min. CONCLUSION On-demand 3D printing of cranial prostheses is a simple, feasible, inexpensive, and rapid solution that may help improve cosmetic outcomes; significantly reduce production time and cost—expanding availability; eliminate the need for reoperation in select cases, reducing morbidity; and has the potential to decrease perioperative complications including infection and resorption.

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Autologous Ear Reconstruction: A Semi-Automatic Procedure for Patient-Specific Surgical Guides

Volume 5: Biomedical and Biotechnology ◽

10.1115/imece2020-23152 ◽

2020 ◽

Author(s):

Elisa Mussi ◽

Rocco Furferi ◽

Michaela Servi ◽

Yary Volpe ◽

Flavio Facchini

Keyword(s):

Surgical Simulation ◽

Hospital Staff ◽

Cartilage Tissue ◽

Patient Specific ◽

Ear Reconstruction ◽

Anatomical Region ◽

Surgical Guides ◽

The Creation ◽

Shape And Size

Abstract Autologous ear reconstruction, i.e. the reconstruction of the outer ear from autologous cartilage tissue, is a very important surgery considering the psychosocial repercussions of an individual affected by microtia (i.e. the total or partial absence of the outer ear). The execution of this surgery can be very complex due to the unique characteristics of this anatomical region. In order to help the surgeon in the process of cutting and suturing, innovative surgical guides were designed that can transmit information about the shape and size of the anatomy to be reconstructed. This work lays the foundation for the creation of a semi-automatic and easy-to-use tool for the modeling of surgical guides. The goal is to make the hospital staff autonomous in the creation of instruments that can be used in pre-surgical simulation and during surgery.

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Immersive 3-Dimensional Virtual Reality Modeling for Case-Specific Presurgical Discussions in Cerebrovascular Neurosurgery

Operative Neurosurgery ◽

10.1093/ons/opaa335 ◽

2020 ◽

Cited By ~ 1

Author(s):

Taku Sugiyama ◽

Tod Clapp ◽

Jordan Nelson ◽

Chad Eitel ◽

Hiroaki Motegi ◽

...

Keyword(s):

Virtual Reality ◽

Surgical Planning ◽

Objective Assessment ◽

Surgical Techniques ◽

Patient Specific ◽

Decision Making Process ◽

3 Dimensional ◽

Head Mounted Display ◽

Precise Understanding ◽

Cerebrovascular Surgery

Abstract BACKGROUND Adequate surgical planning includes a precise understanding of patient-specific anatomy and is a necessity for neurosurgeons. Although the use of virtual reality (VR) technology is emerging in surgical planning and education, few studies have examined the effectiveness of immersive VR during surgical planning using a modern head-mounted display. OBJECTIVE To investigate if and how immersive VR aids presurgical discussions of cerebrovascular surgery. METHODS A multiuser immersive VR system, BananaVisionTM, was developed and used during presurgical discussions in a prospective patient cohort undergoing cerebrovascular surgery. A questionnaire/interview was administered to multiple surgeons after the surgeries to evaluate the effectiveness of the VR system compared to conventional imaging modalities. An objective assessment of the surgeon's knowledge of patient-specific anatomy was also conducted by rating surgeons’ hand-drawn presurgical illustrations. RESULTS The VR session effectively enhanced surgeons’ understanding of patient-specific anatomy in the majority of cases (83.3%). An objective assessment of surgeons’ presurgical illustrations was consistent with this result. The VR session also effectively improved the decision-making process regarding minor surgical techniques in 61.1% of cases and even aided surgeons in making critical surgical decisions about cases involving complex and challenging anatomy. The utility of the VR system was rated significantly higher by trainees than by experts. CONCLUSION Although rated as more useful by trainees than by experts, immersive 3D VR modeling increased surgeons’ understanding of patient-specific anatomy and improved surgical strategy in certain cases involving challenging anatomy.

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