Three-dimensional corrective osteotomy with use of custom-made surgical guides based on computer simulation can provide a good outcome for patients with a malunited diaphyseal forearm fracture.
Step 1: Create Computer Bone Models from CT Data
Obtain CT data of both forearms, and create computer models of the bones from CT data.
Step 2: Evaluate 3D Deformity
Evaluate the 3D deformity by comparing the affected bone with the mirror image of the contralateral, normal bone.
Step 3: Plan 3D Corrective Osteotomy
Simulate the 3D corrective osteotomy on the basis of information obtained from the deformity evaluation.
Step 4: Design Custom-Made Surgical Guides
Design custom-made surgical guides to reproduce the preoperative simulation during the actual surgery.
Step 5: Operative Setup
Manufacture custom-made surgical guides to reproduce the preoperative simulation during the actual surgery.
Step 6: Perform 3D Osteotomy Using Custom-Made Osteotomy Guides
Perform the osteotomy using the custom-made osteotomy guides and achieve anatomical correction using the reduction guides.
In our series of twenty patients, the average radiographic deformity angle preoperatively was 21° (range, 12° to 35°) compared with that of the normal arm; this improved to 1° (range, 0° to 4°) postoperatively
What to Watch For
Pitfalls & Challenges