Patient specific pointer tool for corrective osteotomy: Quality of symmetry based planning and case study of ulnar reconstruction surgery

Malunion after forearm fractures are described to appear in 2% to 10% of cases. Reconstructive surgeries ensure adequate anatomical repositioning. Their importance derives from the fact that malunion can often lead to severe pain as well as deformities causing loss of function and aesthetic issues n...

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Published inInjury Vol. 48; no. 7; pp. 1325 - 1330
Main Authors Mueller, Samuel, Kahrs, Lueder A., Gaa, Johannes, Ortmaier, Tobias, Clausen, Jan-Dierk, Krettek, Christian
Format Journal Article
LanguageEnglish
Published Netherlands Elsevier Ltd 01.07.2017
Subjects
Adult
Computer-Aided Design
Female
Forearm - diagnostic imaging
Fracture
Fracture Fixation, Internal - methods
Fracture Healing
Fractures, Malunited - diagnostic imaging
Fractures, Malunited - surgery
Humans
Male
Malunion
Monteggia
Osteotomy - methods
Patient specific instrument
PSI
Range of Motion, Articular
Reproducibility of Results
Surgery, Computer-Assisted
Surgical planning
Symmetry planning
Tomography, X-Ray Computed
Treatment Outcome
Ulna
Ulna Fractures - diagnostic imaging
Ulna Fractures - surgery
Young Adult
Malunion
Ulna
Monteggia
PSI
Symmetry planning
Fracture
Patient specific instrument
Surgical planning
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Abstract Malunion after forearm fractures are described to appear in 2% to 10% of cases. Reconstructive surgeries ensure adequate anatomical repositioning. Their importance derives from the fact that malunion can often lead to severe pain as well as deformities causing loss of function and aesthetic issues not only in the forearm, but also the wrist and elbow joint. In this paper a clinical case will be presented using a Patient Specific Instrument (PSI) as navigational aid for reconstructive surgery after malunion of a proximal ulnar fracture combined with allograft surgery of the radial head and radial condyle due to chronic traumatic radial head luxation (Monteggia fracture). A planning method based on symmetry is described and evaluated on twelve Computed Tomographic (CT) data sets of intact forearms. The absolute point to point deviation at distal end of the ulnar styloid process was used as a characteristic value for accuracy evaluation. It is 7.9±4.9mm when using only the proximal end of the ulna for registration. The simulated change of ulnar variance is −1.4±1.9mm. Design and concept of the PSI are proven in a clinical trial
AbstractList Malunion after forearm fractures are described to appear in 2% to 10% of cases. Reconstructive surgeries ensure adequate anatomical repositioning. Their importance derives from the fact that malunion can often lead to severe pain as well as deformities causing loss of function and aesthetic issues not only in the forearm, but also the wrist and elbow joint. In this paper a clinical case will be presented using a Patient Specific Instrument (PSI) as navigational aid for reconstructive surgery after malunion of a proximal ulnar fracture combined with allograft surgery of the radial head and radial condyle due to chronic traumatic radial head luxation (Monteggia fracture). A planning method based on symmetry is described and evaluated on twelve Computed Tomographic (CT) data sets of intact forearms. The absolute point to point deviation at distal end of the ulnar styloid process was used as a characteristic value for accuracy evaluation. It is 7.9±4.9mm when using only the proximal end of the ulna for registration. The simulated change of ulnar variance is −1.4±1.9mm. Design and concept of the PSI are proven in a clinical trial
Malunion after forearm fractures are described to appear in 2% to 10% of cases. Reconstructive surgeries ensure adequate anatomical repositioning. Their importance derives from the fact that malunion can often lead to severe pain as well as deformities causing loss of function and aesthetic issues not only in the forearm, but also the wrist and elbow joint. In this paper a clinical case will be presented using a Patient Specific Instrument (PSI) as navigational aid for reconstructive surgery after malunion of a proximal ulnar fracture combined with allograft surgery of the radial head and radial condyle due to chronic traumatic radial head luxation (Monteggia fracture). A planning method based on symmetry is described and evaluated on twelve Computed Tomographic (CT) data sets of intact forearms. The absolute point to point deviation at distal end of the ulnar styloid process was used as a characteristic value for accuracy evaluation. It is 7.9±4.9mm when using only the proximal end of the ulna for registration. The simulated change of ulnar variance is -1.4±1.9mm. Design and concept of the PSI are proven in a clinical trial.
Author Clausen, Jan-Dierk
Krettek, Christian
Kahrs, Lueder A.
Mueller, Samuel
Ortmaier, Tobias
Gaa, Johannes
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  organization: Trauma Department, Hannover Medical School, 30625 Hannover, Germany
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crossref_primary_10_1007_s00113_017_0426_y
crossref_primary_10_1007_s00113_018_0600_x
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Issue 7
Keywords Malunion
Ulna
Monteggia
PSI
Symmetry planning
Fracture
Patient specific instrument
Surgical planning
Language English
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Snippet Malunion after forearm fractures are described to appear in 2% to 10% of cases. Reconstructive surgeries ensure adequate anatomical repositioning. Their...
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SubjectTerms Adult
Computer-Aided Design
Female
Forearm - diagnostic imaging
Fracture
Fracture Fixation, Internal - methods
Fracture Healing
Fractures, Malunited - diagnostic imaging
Fractures, Malunited - surgery
Humans
Male
Malunion
Monteggia
Osteotomy - methods
Patient specific instrument
PSI
Range of Motion, Articular
Reproducibility of Results
Surgery, Computer-Assisted
Surgical planning
Symmetry planning
Tomography, X-Ray Computed
Treatment Outcome
Ulna
Ulna Fractures - diagnostic imaging
Ulna Fractures - surgery
Young Adult
Title Patient specific pointer tool for corrective osteotomy: Quality of symmetry based planning and case study of ulnar reconstruction surgery
URI https://dx.doi.org/10.1016/j.injury.2017.05.012
https://www.ncbi.nlm.nih.gov/pubmed/28549780
https://search.proquest.com/docview/1903160764
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