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Corrective distal radius osteotomy: including bilateral differences in 3-D planning

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Abstract

After a fracture of the distal radius, the bone segments may heal in a suboptimal position. This condition may lead to a reduced hand function, pain and finally osteoarthritis, sometimes requiring corrective surgery. Recent studies report computer-assisted 3-D planning techniques in which the mirrored contralateral unaffected radius serves as reference for planning the position of the distal radius before corrective osteotomy surgery. Bilateral asymmetry, however, may introduce length errors into this type of preoperative planning that can be compensated for by taking into account the concomitant ulnae asymmetry. This article investigates a method for planning a correction osteotomy of the distal radius, while compensating for bilateral length differences using a linear regression model that describes the relationship between radii and ulnae asymmetry. The method is evaluated quantitatively using CT scans of 20 healthy individuals, and qualitatively using CT scans of patients suffering from a malunion of the distal radius. The improved planning method reduces absolute length deviations by a factor of two and markedly reduces positioning variation, from 2.9 ± 2.1 to 1.5 ± 0.6 mm. We expect the method to be of great value for future 3-D planning of a corrective distal radius osteotomy.

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Acknowledgments

This work was partly supported by ITEA-2 project 09039, Mediate.

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Authors and Affiliations

  1. Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Room no. L0-113-3, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands

    J. G. G. Dobbe & G. J. Streekstra

  2. Department of Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands

    J. C. Vroemen & S. D. Strackee

Authors
  1. J. G. G. Dobbe
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  2. J. C. Vroemen
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  3. S. D. Strackee
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  4. G. J. Streekstra
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Correspondence to J. G. G. Dobbe.

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Dobbe, J.G.G., Vroemen, J.C., Strackee, S.D. et al. Corrective distal radius osteotomy: including bilateral differences in 3-D planning. Med Biol Eng Comput 51, 791–797 (2013). https://doi.org/10.1007/s11517-013-1049-2

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  • DOI: https://doi.org/10.1007/s11517-013-1049-2

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