Corrective osteotomy for malunited both bones fractures of the forearm with radial head dislocations using a custom-made surgical guide: two case reports

The study of CAD (computer aided design) modeling, design and manufacturing techniques has undergone a rapid growth over the past decades. In medicine, this development mainly concerned the dental and maxillofacial sectors. Significant progress has also been made in orthopedics with pre-operative CAD simulations, printing of bone models and production of patient-specific instruments. However, the traditional procedure that formulates the surgical plan based exclusively on two-dimensional images and interventions performed without the aid of specific instruments for the patient and is currently the most used surgical technique. The production of custom-made tools for the patient, in fact, is often expensive and its use is limited to a few hospitals. The purpose of this study is to show an innovative and cost-effective procedure aimed at prototyping a custom-made surgical guide for address the cubitus varus deformity on a pediatric patient. The cutting guides were obtained through an additive manufacturing process that starts from the 3D digital model of the patient’s bone and allows to design specific models using Creo Parametric. The result is a tool that adheres perfectly to the patient’s bone and guides the surgeon during the osteotomy procedure. The low cost of the methodology described makes it worth noticing by any health institution.

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Radius and Ulna Trauma

Musculoskeletal Imaging Volume 1 ◽

10.1093/med/9780190938161.003.0015 ◽

2019 ◽

pp. 65-67

Author(s):

Michael O’Keeffe ◽

Kiran Khursid ◽

Peter L. Munk ◽

Mihra S. Taljanovic

Keyword(s):

Radial Head ◽

Distal Radioulnar Joint ◽

Monteggia Fracture ◽

Radial Head Fractures ◽

Type Iv ◽

Ulnar Fracture ◽

Fracture Dislocations ◽

Diaphyseal Fractures ◽

Both Bones ◽

Essex Lopresti

Chapter 15 discusses radius and ulna trauma. Forearm fractures are common and may be isolated to the ulna or more commonly involve both bones. Fractures of the radius or ulna are usually because of direct trauma and are often displaced. Depending on their complexity, isolated fractures of the ulnar diaphysis may be treated nonoperatively or operatively whereas both bone (radius and ulna) diaphyseal fractures are typically treated operatively. Galeazzi fracture-dislocations are comprised of radial diaphyseal fractures in association with distal radioulnar joint (DRUJ) dislocation/subluxation. Monteggia fracture-dislocations are comprised of a proximal ulnar fracture in association with radial head dislocation. In type IV Monteggia injuries, there is an additional fracture of the proximal radial diaphysis. Essex-Lopresti fracture-dislocations include radial head fractures in association with DRUJ dislocation/subluxation.

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Three-Dimensional Corrective Osteotomy for Malunited Diaphyseal Forearm Fractures Using Custom-Made Surgical Guides Based on Computer Simulation

JBJS Essential Surgical Techniques ◽

10.2106/jbjs.st.l.00022 ◽

2012 ◽

Vol 2 (4) ◽

pp. e24 ◽

Cited By ~ 4

Author(s):

Junichi Miyake ◽

Tsuyoshi Murase ◽

Kunihiro Oka ◽

Hisao Moritomo ◽

Kazuomi Sugamoto ◽

...

Keyword(s):

Computer Simulation ◽

Corrective Osteotomy ◽

Three Dimensional ◽

Forearm Fractures ◽

Surgical Guides ◽

Custom Made

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An Undescribed Monteggia Type 3 Equivalent Lesion: Lateral Dislocation of Radial Head with Both-Bone Forearm Fracture

Case Reports in Orthopedics ◽

10.1155/2016/8598139 ◽

2016 ◽

Vol 2016 ◽

pp. 1-5

Author(s):

Adnan Kara ◽

Mahmut Enes Kayaalp ◽

Mehmet İşyar ◽

Cem Sever ◽

Melih Malkoç ◽

...

Keyword(s):

Radial Head ◽

Closed Reduction ◽

Forearm Fracture ◽

Diagnosis And Treatment ◽

Lateral Dislocation ◽

Both Bones ◽

Type 3

Monteggia fractures are accepted as hard-to-recognize and easy-to-handle fractures. Adequate radiographic investigations and clinical examinations are necessities. This case holds unique features involving diagnosis and treatment. In this case, the radial head was dislocated laterally while both bones were fractured in the proximal diaphysis, being the first to be mentioned in the literature. Closed reduction of the ulna is the preferred method of handling and almost always results in reduction of the radial head. Literature obligates ulnar reduction as a preliminary to reduce and stabilize the radial head. Closed reduction reduced the ulna but the radial head was not reduced. Hence an intramedullary K-wire was used to reduce the radial head and a long arm cast was used to stabilize the reduction. The operation was successful and follow-up showed no complications.

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