scholarly journals Three-dimensional evaluations of preoperative planning reproducibility for the osteosynthesis of distal radius fractures

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Yuichi Yoshii ◽  
Takeshi Ogawa ◽  
Atsuo Shigi ◽  
Kunihiro Oka ◽  
Tsuyoshi Murase ◽  
...  
Keyword(s):  
Distal Radius ◽  
Reference Point ◽  
Preoperative Planning ◽  
Three Dimensional ◽  
Reference Points ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
3D Images ◽  
Radial Inclination ◽  
Preoperative Plan

Abstract Background Three-dimensional preoperative planning was applied for the osteosynthesis of distal radius fractures. The objective of this study was to evaluate the reproducibility of three-dimensional preoperative planning for the osteosynthesis of distal radius fractures with three-dimensional reference points. Methods Sixty-three wrists of 63 distal radius fracture patients who underwent osteosynthesis with three-dimensional preoperative planning were evaluated. After taking preoperative CT scans of the injured wrists, 3D images of the distal radius were created. Fracture reduction, implants choices, and placements simulation were performed based on the 3D images. One month after the surgery, postoperative CT images were taken. The reproducibility was evaluated with preoperative plan and postoperative 3D images. The images were compared with the three-dimensional coordinates of radial styloid process, volar and dorsal edges of sigmoid notch, and the barycentric coordinates of the three reference points. The reproducibility of the preoperative plan was evaluated by the distance of the coordinates between the plan and postoperative images for the reference points. The reproducibility of radial inclination and volar tilt on three-dimensional images were evaluated by intra-class correlation coefficient (ICC). Results The distances between the preoperative plan and the postoperative reduction for each reference point were (1) 2.1±1.3 mm, (2) 1.9±1.2 mm, and (3) 1.9±1.2 mm, respectively. The distance between the preoperative plan and postoperative reduction for the barycentric coordinate was 1.3±0.8 mm. ICCs were 0.54 and 0.54 for the volar tilt and radial inclination, respectively (P<0.01). Conclusions Three-dimensional preoperative planning for the osteosynthesis of distal radius fracture was reproducible with an error of about 2 mm for each reference point and the correlations of reduction shapes were moderate. The analysis method and reference points may be helpful to understand the accuracy of reductions for the three-dimensional preoperative planning in the osteosynthesis of distal radius fractures. Trial registration Registered as NCT02909647 at ClinicalTrials.gov

scholarly journals Computer-Aided Assessment of Displacement and Reduction of Distal Radius Fractures

Diagnostics ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. 719
Author(s):  
Yuichi Yoshii ◽  
Yasukazu Totoki ◽  
Atsuo Shigi ◽  
Kunihiro Oka ◽  
Takeshi Ogawa ◽  
...  
Keyword(s):  
Distal Radius ◽  
Reference Point ◽  
Three Dimensional ◽  
Reference Points ◽  
Distal Radius Fractures ◽  
Barycentric Coordinates ◽  
Radius Fractures ◽  
3D Images ◽  
Computer Aided ◽  
Distal Direction

This study aims to investigate displacements and reductions of distal radius fractures using measurement indices based on the computer-aided three-dimensional (3D) radius shape model. Fifty-two distal radius fracture patients who underwent osteosynthesis were evaluated with pre- and post-operative distal radius 3D images. In the 3D images, three reference points, i.e., the radial styloid process (1), sigmoid notch volar, and dorsal edge (2) (3) were marked. The three-dimensional coordinates of each reference point and the barycentric coordinates of the plane connecting the three reference points were evaluated. The distance and direction moved, due to the reductions for each reference point, were (1) 12.1 ± 8.1 mm in the ulnar-palmar-distal direction, (2) 7.5 ± 4.1 mm in the ulnar-palmar-proximal direction, and (3) 8.2 ± 4.7 mm in the ulnar-palmar-distal direction relative to the preoperative position. The barycentric coordinate moved 8.4 ± 5.3 mm in the ulnar-palmar-distal direction compared to the preoperative position. This analyzing method will be helpful to understand the three-dimensional direction and the extent of displacements in distal radius fractures.

scholarly journals A modified intrafocal pinning technique with three‐dimensional planning to facilitate volar plating in dorsally comminuted AO/OTA C2 and C3 distal radius fractures

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Xue-yang Gui ◽  
Hong-fei Shi ◽  
Jin Xiong ◽  
Yi-xin Chen ◽  
Jun-fei Wang ◽  
...  
Keyword(s):  
Distal Radius ◽  
Locking Plate ◽  
Preoperative Planning ◽  
Three Dimensional ◽  
Distal Radius Fractures ◽  
Dash Score ◽  
Volar Plating ◽  
Radius Fractures ◽  
Radial Inclination

Abstract Backgrounds Theaim of this study was to assess the efficacy of a modified intrafocal pinningtechnique with three-dimensional (3D) planning to facilitate volar plating in dorsally comminuted intra-articular distal radius fractures. Methods Intotal 35 AO/OTA type C2 and C3 fractures were finally included.The 3D digital model of the fracture was reconstructed based on preoperative computedtomographic (CT) images, with the displacement of the comminuted dorsalfragment and the intra-articular fragment analyzed for preoperative planning. During operation, amodified intrafocal pinning technique was applied percutaneously from thedorsal aspect of the radius to reduce the collapsed intra-articular fragmentfollowing volar plating. Adequate reduction was confirmed in all of patientsconsidering radial height, radial inclination and volar tilt in postoperativeradiographs. Results No significant fracture re-displacement wasobserved in most of the cases during a mean follow-up period of 17.4 months, exceptfor two patients withthe C3 fracture. All of the patients achieved adequate clinicalROMs at 12 months postoperatively, with a mean DASH score of 12.0. Most of the patients achievedan excellent (n = 21) or good (n = 12) Gartland and Werley wrist score. Conclusions Ourmodified intrafocal pinning technique with 3D planning contributes to a satisfactoryclinical and radiological outcome in dorsally comminuted intra-articular distalradius fractures fixed with a volar locking plate. Trialregistration Notapplicable because the design of the study is retrospective.

scholarly journals Reproducibility of three dimensional digital preoperative planning for the osteosynthesis of distal radius fractures

2017 ◽  
Vol 35 (12) ◽  
pp. 2646-2651 ◽  
Author(s):  
Yuichi Yoshii ◽  
Takuya Kusakabe ◽  
Kenichi Akita ◽  
Wen Lin Tung ◽  
Tomoo Ishii
Keyword(s):  
Distal Radius ◽  
Preoperative Planning ◽  
Three Dimensional ◽  
Distal Radius Fractures ◽  
Radius Fractures

Screw Length Optimization of a Volar Locking Plate Using Three Dimensional Preoperative Planning in Distal Radius Fractures

2018 ◽  
Vol 23 (04) ◽  
pp. 520-527 ◽  
Author(s):  
Yasukazu Totoki ◽  
Yuichi Yoshii ◽  
Takuya Kusakabe ◽  
Kenichi Akita ◽  
Tomoo Ishii
Keyword(s):  
Distal Radius Fracture ◽  
Distal Radius ◽  
Preoperative Planning ◽  
Three Dimensional ◽  
Distal Radius Fractures ◽  
Control Group ◽  
3D Image ◽  
Radius Fractures ◽  
Screw Length ◽  
Operative Planning

Background: A three-dimensional (3D) digital pre-operative planning system for the osteosynthesis of distal radius fracture was developed. The objective of this study was to evaluate screw choices for three-dimensional (3D) digital pre-operative planning of osteosynthesis of distal radius fractures and to compare with the screw choices for the conventional method.Methods: Distal radius fracture patients who underwent osteosynthesis using volar locking plates were evaluated. Thirty wrists in the plan group utilized 3D preoperative planning, and nineteen wrists in the control group utilized conventional preoperative assessment. In the plan group, the 3D preoperative planning was performed prior to surgery. The reduction was simulated with 3D image, and the implant choice/placement also simulated on the 3D image. In the control group, standard preoperative planning was performed using posterior-anterior and lateral view radiographs, and CT scan. After the planning, osteosynthesis was performed. During the surgery, the operator performed the reduction and the placement of the plate while comparing images between the pre-operative plan and fluoroscopy. The distal screw lengths and the anteroposterior diameter of the radius along the axis of the distal screws were measured. The ratios of the screw length and radius diameter were evaluated. The screw/radius ratios within the range of 0.75–1.00 were considered appropriate. The screw choices less than 0.75, or greater than 1.00 were considered inappropriate. The rate of appropriate screw choices were compared between plan and control groups.Results: The results of appropriate screw choices were 86.1% and 74.8% in the plan group and the control group, respectively. The inappropriate screw choices were 14.0% and 25.2% in the plan group and the control group, respectively. The three-dimensional planning significantly increased appropriate screw choices compared to the conventional planning (p < 0.05).Conclusions: Three-dimensional digital preoperative planning is useful for the optimization of screw lengths in osteosynthesis of distal radius fractures.

CLINICAL APPLICATION OF DOUBLE DORSAL PLATES FOR THE DISTAL RADIUS FRACTURES

Hand Surgery ◽  
2005 ◽  
Vol 10 (02n03) ◽  
pp. 213-224
Author(s):  
Noriyuki Yoshida ◽  
Kazuhiko Matsushita ◽  
Takeshi Arai ◽  
Ko Izumiyama ◽  
Moroe Beppu ◽  
...  
Keyword(s):  
Cortical Bone ◽  
Clinical Application ◽  
Distal Radius ◽  
Three Dimensional ◽  
Clinical Results ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Radial Margin ◽  
Dimensional Models ◽  
Three Dimensional Models

The purpose of this study was to develop plates that fit the contour of the distal radius of the Japanese and can be inserted less invasively. Three-dimensional models of 36 radii of 18 volunteers were prepared. Using these models, the shape of the cortical bone on the radial margin of the distal radius and just below the dorsal fourth compartment of the wrist, to which the plates were expected to be applied, was measured, and the curves of the plates were determined. The functions of approximated curves of the plates were: [ y = -2 × 10-8 x 5 - 2 × 10-6 x 4 + 0.0006 x 3 - 0.0312 x 2 + 0.3274 x + 15.224 on the radial margin of the distal radius and [ y = 7 × 10-7 x 5 - 0.0001 x 4 + 0.0078 x 3 - 0.2355 x 2 + 3.1815 x - 5.6383 just below the fourth compartment. The clinical results of the application of double dorsal plates were satisfactory in clinical cases for the distal radius fractures.

Three-dimensional in vivo kinematics of the distal radioulnar joint in malunited distal radius fractures

2002 ◽  
Vol 27 (2) ◽  
pp. 233-242 ◽  
Author(s):  
Douglas C. Moore ◽  
Kathleen A. Hogan ◽  
Joseph J. Crisco ◽  
Edward Akelman ◽  
Manuel F. DaSilva ◽  
...  
Keyword(s):  
Distal Radius ◽  
Three Dimensional ◽  
Distal Radioulnar Joint ◽  
Distal Radius Fractures ◽  
Radius Fractures ◽  
Radioulnar Joint ◽  
In Vivo Kinematics

USE OF THE VOLAR FIXED ANGLE PLATE FOR COMMINUTED DISTAL RADIUS FRACTURES AND AUGMENTATION WITH A HYDROXYAPATITE BONE GRAFT SUBSTITUTE

Hand Surgery ◽  
2011 ◽  
Vol 16 (01) ◽  
pp. 29-37 ◽  
Author(s):  
Akira Goto ◽  
Tsuyoshi Murase ◽  
Kunihiro Oka ◽  
Hideki Yoshikawa
Keyword(s):  
Elderly Patients ◽  
Bone Graft ◽  
Distal Radius ◽  
Bone Graft Substitute ◽  
Distal Radius Fractures ◽  
Ulnar Variance ◽  
Radius Fractures ◽  
Fixed Angle ◽  
Radial Inclination ◽  
Metaphyseal Comminution

Treatment of distal radius fractures with a volar fixed angle plate achieves sufficient stabilisation and permits early physical exercise. However, secondary displacement after surgery sometimes occurs in elderly patients with a metaphyseal comminution and/or cases in which the subchondral support pegs were not placed immediately below the subchondral zone.We treated elderly patients suffering from distal radius fractures with metaphyseal comminution, using both volar fixed angle plate with or without augmentation with a hydroxyapatite bone graft substitute to investigate the benefit of augmentation for maintaining a fracture reduction. We evaluated the differences among radiographic parameters including palmar tilt, radial inclination, and ulnar variance on immediate postoperative and final follow-up radiographs to analyse the maintenance of the initial reduction.There were no significant differences between the two groups in terms of palmar tilt (P = 0.80) and radial inclination (P = 0.17); however, ulnar variance increased significantly in the group treated with a volar fixed angle plate without augmentation (P < 0.05).It might be useful to use a combination technique of a locking plate system and the hydroxyapatite bone graft substitute as augmentation to treat distal radius comminuted fractures in elderly patients.

Three-dimensional deformity analysis of malunited distal radius fractures and their influence on wrist and forearm motion

2012 ◽  
Vol 37 (6) ◽  
pp. 506-512 ◽  
Author(s):  
J. Miyake ◽  
T. Murase ◽  
Y. Yamanaka ◽  
H. Moritomo ◽  
K. Sugamoto ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Distal Radius ◽  
Three Dimensional ◽  
Axial Rotation ◽  
Computer Models ◽  
Distal Radius Fractures ◽  
Wrist Flexion ◽  
Radius Fractures ◽  
Ct Data ◽  
Flexion And Extension

Little information exists about three-dimensional (3-D) deformity patterns of malunited distal radius fractures including axial deformity. The current study aimed to clarify the 3-D deformity pattern of malunited distal radius fractures and reveal the influence of osseous deformities, including axial rotation deformity, on wrist and forearm motion. The deformity of 20 dorsally tilted malunions were evaluated using 3-D computer models created from CT data, and correlations between deformity components and range of motion were assessed. The 3-D deformity analysis showed that axial malalignment in pronation, which showed a correlation with the degree of radial tilt deformity, was very common. A radial tilt deformity of > 5° was observed in only 45% of cases. Although the range of wrist flexion and extension showed a correlation with dorsal tilt deformity, the range of forearm pronation and supination did not correlate with distal radius deformities.

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