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Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures

Background and Objectives: 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 appr...

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Autores principales: Pastor, Tatjana, Nagy, Ladislav, Fürnstahl, Philipp, Roner, Simon, Pastor, Torsten, Schweizer, Andreas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227146/
https://www.ncbi.nlm.nih.gov/pubmed/35744007
http://dx.doi.org/10.3390/medicina58060744
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author Pastor, Tatjana
Nagy, Ladislav
Fürnstahl, Philipp
Roner, Simon
Pastor, Torsten
Schweizer, Andreas
author_facet Pastor, Tatjana
Nagy, Ladislav
Fürnstahl, Philipp
Roner, Simon
Pastor, Torsten
Schweizer, Andreas
author_sort Pastor, Tatjana
collection PubMed
description Background and Objectives: 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. Materials and Methods: 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. Results: 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. Conclusions: 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.
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spelling pubmed-92271462022-06-25 Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures Pastor, Tatjana Nagy, Ladislav Fürnstahl, Philipp Roner, Simon Pastor, Torsten Schweizer, Andreas Medicina (Kaunas) Article Background and Objectives: 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. Materials and Methods: 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. Results: 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. Conclusions: 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. MDPI 2022-05-30 /pmc/articles/PMC9227146/ /pubmed/35744007 http://dx.doi.org/10.3390/medicina58060744 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Pastor, Tatjana
Nagy, Ladislav
Fürnstahl, Philipp
Roner, Simon
Pastor, Torsten
Schweizer, Andreas
Three-Dimensional Planning and Patient-Specific Instrumentation for the Fixation of Distal Radius Fractures
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9227146/
https://www.ncbi.nlm.nih.gov/pubmed/35744007
http://dx.doi.org/10.3390/medicina58060744
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