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Clinical Orthopaedics and Related Research®

Published in:

01-06-2011 | Clinical Research

Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation

Authors: Junichi Miyake, MD, Tsuyoshi Murase, MD, PhD, Hisao Moritomo, MD, PhD, Kazuomi Sugamoto, MD, PhD, Hideki Yoshikawa, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 6/2011

Abstract

Background

Corrective osteotomy using dorsal plates and structural bone graft usually has been used for treating symptomatic distal radius malunions. However, the procedure is technically demanding and requires an extensive dorsal approach. Residual deformity is a relatively frequent complication of this technique.

Questions/purposes

We evaluated the clinical applicability of a three-dimensional osteotomy using computer-aided design and manufacturing techniques with volar locking plates for distal radius malunions.

Patients and Methods

Ten patients with metaphyseal radius malunions were treated. Corrective osteotomy was simulated with the help of three-dimensional bone surface models created using CT data. We simulated the most appropriate screw holes in the deformed radius using computer-aided design data of a locking plate. During surgery, using a custom-made surgical template, we predrilled the screw holes as simulated. After osteotomy, plate fixation using predrilled screw holes enabled automatic reduction of the distal radial fragment. Autogenous iliac cancellous bone was grafted after plate fixation.

Results

The median volar tilt, radial inclination, and ulnar variance improved from −20°, 13°, and 6 mm, respectively, before surgery to 12°, 24°, and 1 mm, respectively, after surgery. The median wrist flexion improved from 33° before surgery to 60° after surgery. The median wrist extension was 70° before surgery and 65° after surgery. All patients experienced wrist pain before surgery, which disappeared or decreased after surgery.

Conclusions

Surgeons can operate precisely and easily using this advanced technique. It is a new treatment option for malunion of distal radius fractures.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Available only for authorised users

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Title: Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation
Authors: Junichi Miyake, MD
Tsuyoshi Murase, MD, PhD
Hisao Moritomo, MD, PhD
Kazuomi Sugamoto, MD, PhD
Hideki Yoshikawa, MD, PhD
Publication date: 01-06-2011
Publisher: Springer-Verlag
Published in: Clinical Orthopaedics and Related Research® / Issue 6/2011
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-010-1748-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Distal Radius Osteotomy with Volar Locking Plates Based on Computer Simulation

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Questions/purposes

Patients and Methods

Results

Conclusions

Level of Evidence

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