Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures
<i>Background and Objectives</i>: Three-dimensional planning and guided osteotomy utilizing patient-specific instrumentation (PSI) with the contralateral side used as a reference have been proven as effective in the treatment of malunions following complex fractures of the distal radius....
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-05-01
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| Series: | Medicina |
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| Online Access: | https://www.mdpi.com/1648-9144/58/6/744 |
| _version_ | 1797484619715575808 |
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| author | Tatjana Pastor Ladislav Nagy Philipp Fürnstahl Simon Roner Torsten Pastor Andreas Schweizer |
| author_facet | Tatjana Pastor Ladislav Nagy Philipp Fürnstahl Simon Roner Torsten Pastor Andreas Schweizer |
| author_sort | Tatjana Pastor |
| collection | DOAJ |
| description | <i>Background and Objectives</i>: Three-dimensional planning and guided osteotomy utilizing patient-specific instrumentation (PSI) with the contralateral side used as a reference have been proven as effective in the treatment of malunions following complex fractures of the distal radius. However, this approach has not yet been described in relation to fracture reduction of the distal radius. The aim of this study was to assess the technical and logistical feasibility of computer-assisted surgery in a clinical setting using PSI for fracture reduction and fixation. <i>Materials and Methods</i>: Five patients with varied fracture patterns of the distal radius underwent operative treatment with using PSI. The first applied PSI guide allowed specific and accurate placement of Kirschner wires inside the multiple fragments, with subsequent concurrent reduction using a second guide. <i>Results</i>: Planning, printing of the guides, and operations were performed within 5.6 days on average (range of 1–10 days). All patients could be treated within a reasonable period of time, demonstrating good outcomes, and were able to return to work after a follow-up of three months. Mean wrist movements (°) were 58 (standard deviation (SD) 21) in flexion, 62 (SD 15) in extension, 73 (SD 4) in pronation and 74 (SD 10) in supination at a minimum follow-up of 6 months. <i>Conclusions</i>: Three-dimensional planned osteosynthesis using PSI for treatment of distal radius fractures is feasible and facilitates reduction of multiple fracture fragments. However, higher costs must be taken into consideration for this treatment. |
| first_indexed | 2024-03-09T23:07:03Z |
| format | Article |
| id | doaj.art-99e4367971aa401f91d5943dba03ac57 |
| institution | Directory Open Access Journal |
| issn | 1010-660X 1648-9144 |
| language | English |
| last_indexed | 2024-03-09T23:07:03Z |
| publishDate | 2022-05-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Medicina |
| spelling | doaj.art-99e4367971aa401f91d5943dba03ac572023-11-23T17:51:49ZengMDPI AGMedicina1010-660X1648-91442022-05-0158674410.3390/medicina58060744Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius FracturesTatjana Pastor0Ladislav Nagy1Philipp Fürnstahl2Simon Roner3Torsten Pastor4Andreas Schweizer5Department of Hand Surgery, Balgrist University Hospital, University of Zurich, 8008 Zurich, SwitzerlandDepartment of Hand Surgery, Balgrist University Hospital, University of Zurich, 8008 Zurich, SwitzerlandComputer-Assisted Research and Development Team, Balgrist University Hospital, University of Zurich, 8008 Zurich, SwitzerlandDepartment of Hand Surgery, Balgrist University Hospital, University of Zurich, 8008 Zurich, SwitzerlandDepartment of Hand Surgery, Balgrist University Hospital, University of Zurich, 8008 Zurich, SwitzerlandDepartment of Hand Surgery, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland<i>Background and Objectives</i>: Three-dimensional planning and guided osteotomy utilizing patient-specific instrumentation (PSI) with the contralateral side used as a reference have been proven as effective in the treatment of malunions following complex fractures of the distal radius. However, this approach has not yet been described in relation to fracture reduction of the distal radius. The aim of this study was to assess the technical and logistical feasibility of computer-assisted surgery in a clinical setting using PSI for fracture reduction and fixation. <i>Materials and Methods</i>: Five patients with varied fracture patterns of the distal radius underwent operative treatment with using PSI. The first applied PSI guide allowed specific and accurate placement of Kirschner wires inside the multiple fragments, with subsequent concurrent reduction using a second guide. <i>Results</i>: Planning, printing of the guides, and operations were performed within 5.6 days on average (range of 1–10 days). All patients could be treated within a reasonable period of time, demonstrating good outcomes, and were able to return to work after a follow-up of three months. Mean wrist movements (°) were 58 (standard deviation (SD) 21) in flexion, 62 (SD 15) in extension, 73 (SD 4) in pronation and 74 (SD 10) in supination at a minimum follow-up of 6 months. <i>Conclusions</i>: Three-dimensional planned osteosynthesis using PSI for treatment of distal radius fractures is feasible and facilitates reduction of multiple fracture fragments. However, higher costs must be taken into consideration for this treatment.https://www.mdpi.com/1648-9144/58/6/744distal radius fracture3D planningpatient-specific guidepreoperative planningosteosynthesis |
| spellingShingle | Tatjana Pastor Ladislav Nagy Philipp Fürnstahl Simon Roner Torsten Pastor Andreas Schweizer Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures Medicina distal radius fracture 3D planning patient-specific guide preoperative planning osteosynthesis |
| title | Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures |
| title_full | Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures |
| title_fullStr | Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures |
| title_full_unstemmed | Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures |
| title_short | Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures |
| title_sort | three dimensional planning and patient specific instrumentation for the fixation of distal radius fractures |
| topic | distal radius fracture 3D planning patient-specific guide preoperative planning osteosynthesis |
| url | https://www.mdpi.com/1648-9144/58/6/744 |
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