Three-Dimensional Corrective Osteotomy for Malunited Fractures of the Upper Extremity Using Patient-Matched Instruments

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.

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Three-dimensional joint kinematics of the upper extremity in reach movements under whole-body vibration exposure

PsycEXTRA Dataset ◽

10.1037/e578222012-001 ◽

2008 ◽

Author(s):

Heon-Jeong Kim ◽

Bernard J. Martin

Keyword(s):

Upper Extremity ◽

Whole Body Vibration ◽

Three Dimensional ◽

Joint Kinematics ◽

Whole Body ◽

Vibration Exposure ◽

Body Vibration ◽

Reach Movements

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Three-dimensional corrective osteotomy using a patient-specific osteotomy guide and bone plate based on a computer simulation system: accuracy analysis in a cadaver study

International Journal of Medical Robotics and Computer Assisted Surgery ◽

10.1002/rcs.1530 ◽

2013 ◽

Vol 10 (2) ◽

pp. 196-202 ◽

Cited By ~ 27

Author(s):

Shinsuke Omori ◽

Tsuyoshi Murase ◽

Toshiyuki Kataoka ◽

Yohei Kawanishi ◽

Keiichiro Oura ◽

...

Keyword(s):

Computer Simulation ◽

Corrective Osteotomy ◽

Three Dimensional ◽

Cadaver Study ◽

Simulation System ◽

Bone Plate ◽

Patient Specific ◽

Accuracy Analysis

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Motion Analytics of Trapezius Muscle Activity in an 18-Year-Old Female with Extended Upper Brachial Plexus Birth Palsy

Journal of Brachial Plexus and Peripheral Nerve Injury ◽

10.1055/s-0041-1731748 ◽

2021 ◽

Vol 16 (01) ◽

pp. e51-e55

Author(s):

Jasmine J. Lin ◽

Gromit Y.Y. Chan ◽

Cláudio T. Silva ◽

Luis G. Nonato ◽

Preeti Raghavan ◽

...

Keyword(s):

Brachial Plexus ◽

Upper Extremity ◽

Muscle Activity ◽

Visual Analytics ◽

Three Dimensional ◽

Trapezius Muscle ◽

Shoulder Abduction ◽

Upper Trapezius ◽

Brachial Plexus Birth Palsy ◽

Birth Palsy

Abstract Background The trapezius muscle is often utilized as a muscle or nerve donor for repairing shoulder function in those with brachial plexus birth palsy (BPBP). To evaluate the native role of the trapezius in the affected limb, we demonstrate use of the Motion Browser, a novel visual analytics system to assess an adolescent with BPBP. Method An 18-year-old female with extended upper trunk (C5–6–7) BPBP underwent bilateral upper extremity three-dimensional motion analysis with Motion Browser. Surface electromyography (EMG) from eight muscles in each limb which was recorded during six upper extremity movements, distinguishing between upper trapezius (UT) and lower trapezius (LT). The Motion Browser calculated active range of motion (AROM), compiled the EMG data into measures of muscle activity, and displayed the results in charts. Results All movements, excluding shoulder abduction, had similar AROM in affected and unaffected limbs. In the unaffected limb, LT was more active in proximal movements of shoulder abduction, and shoulder external and internal rotations. In the affected limb, LT was more active in distal movements of forearm pronation and supination; UT was more active in shoulder abduction. Conclusion In this female with BPBP, Motion Browser demonstrated that the native LT in the affected limb contributed to distal movements. Her results suggest that sacrificing her trapezius as a muscle or nerve donor may affect her distal functionality. Clinicians should exercise caution when considering nerve transfers in children with BPBP and consider individualized assessment of functionality before pursuing surgery.

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Spatial Kinematic Analysis of the Upper Extremity Using a Biplanar Videotaping Method

Journal of Biomechanical Engineering ◽

10.1115/1.3138237 ◽

1981 ◽

Vol 103 (1) ◽

pp. 11-17 ◽

Cited By ~ 21

Author(s):

N. A. Langrana

Keyword(s):

Upper Extremity ◽

Dimensional Space ◽

Three Dimensional ◽

Assistive Device ◽

Kinematic Data ◽

Computer Aided ◽

Extremity Motion ◽

Accuracy And Repeatability ◽

Three Dimensional Space

A biplanar videotaping system is used to generate spatial kinematic data of an upper extremity motion. The technique is based upon the characterization of each segment by four points in three-dimensional space using biplanar videotaping and subsequent analysis by computer-aided descriptive geometry. The tests were conducted to determine the system’s accuracy and repeatability. The results of the joint kinematics of the test subjects performing a diagonal reaching activity with and without an orthosis (or an assistive device) are presented.

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