Med Biol Eng Comput - Computer-assisted and patient-specific 3-D planning and evaluation of a single-cut rotational osteotomy for complex long-bone deformities.

Tópicos

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Resumo

Malunion after long bone fracture results in an incorrect position of the distal bone segment. This misalignment may lead to reduced function of the limb, early osteoarthritis and chronic pain. An established treatment option is a corrective osteotomy. For complex malunions, a single-cut rotational osteotomy is sometimes preferred in cases of angular deformity in three dimensions. However, planning and performing this type of osteotomy is relatively complex. This report describes a computer-assisted method for 3-D planning and realizing a single-cut rotational osteotomy with a patient-specific cutting guide for orienting the osteotomy and an angled jig for adjusting the rotation angle. The accuracy and reproducibility of the method is evaluated experimentally using plastic bones. In addition, complex rotational deformities are simulated by a computer to investigate the relation between deformity and correction parameters. The computed relation between deformity and correction parameters enables the surgeon to judge the feasibility of a single-cut rotational osteotomy. This appears possible for deformities combining axial misalignment with sufficient axial rotation. The proposed 3-D method of preoperative planning and transfer with a patient-specific cutting guide and angled jig renders the osteotomy procedure easily applicable, accurate, reproducible, and is a good alternative for complex and expensive navigation systems.

Resumo Limpo

malunion long bone fractur result incorrect posit distal bone segment misalign may lead reduc function limb earli osteoarthr chronic pain establish treatment option correct osteotomi complex malunion singlecut rotat osteotomi sometim prefer case angular deform three dimens howev plan perform type osteotomi relat complex report describ computerassist method d plan realiz singlecut rotat osteotomi patientspecif cut guid orient osteotomi angl jig adjust rotat angl accuraci reproduc method evalu experiment use plastic bone addit complex rotat deform simul comput investig relat deform correct paramet comput relat deform correct paramet enabl surgeon judg feasibl singlecut rotat osteotomi appear possibl deform combin axial misalign suffici axial rotat propos d method preoper plan transfer patientspecif cut guid angl jig render osteotomi procedur easili applic accur reproduc good altern complex expens navig system

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