Computer-assisted extra-articular distal radius osteotomies using patient-specific surgical guides

10.29007/svbd ◽  
2018 ◽  
Author(s):  
Vasilii Shishkin ◽  
Valeriy Golubev
Keyword(s):  
Distal Radius ◽  
Patient Specific ◽  
Control Group ◽  
Computer Assisted ◽  
X Ray ◽  
Surgical Guides ◽  
Planning Approach ◽  
3D Printed ◽  
Planning Group

Malunions of the distal radius are often treated with correction osteotomies, which can be challenging to perform.In this report, 23 patients with symptomatic distal radius malunions were treated using 3D printed patient-specific surgical guides to facilitate surgery. Patients were compared with a control group of 23 patients that underwent similar surgery with a conventional x-ray planning approach.Postoperatively all patients in the computer-assisted group showed recovery of ROM, with no anatomical abnormalities on x-ray examination. 6 patients in the conventional planning group had reduced ROM with a residual volar tilt on x-ray images.Computer-assisted planning with the use of 3D printed patient-specific surgical guides enhances results of corrective osteotomies of distal radius malunions.

scholarly journals In-house 3D-printed surgical guides for osseous lesions of the lower jaw: an experimental study

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Lukas Postl ◽  
Thomas Mücke ◽  
Stefan Hunger ◽  
Oliver Bissinger ◽  
Michael Malek ◽  
...  
Keyword(s):  
Control Group ◽  
Head Model ◽  
Computer Assisted ◽  
3D Printer ◽  
Surgical Guide ◽  
Surgical Guides ◽  
Lower Jaw ◽  
Bony Lesion ◽  
3D Printed ◽  
Phantom Head

Abstract Background The accuracy of computer-assisted biopsies at the lower jaw was compared to the accuracy of freehand biopsies. Methods Patients with a bony lesion of the lower jaw with an indication for biopsy were prospectively enrolled. Two customized bone models per patient were produced using a 3D printer. The models of the lower jaw were fitted into a phantom head model to simulate operation room conditions. Biopsies for the study group were taken by means of surgical guides and freehand biopsies were performed for the control group. Results The deviation of the biopsy axes from the planning was significantly less when using templates. It turned out to be 1.3 ± 0.6 mm for the biopsies with a surgical guide and 3.9 ± 1.1 mm for the freehand biopsies. Conclusions Surgical guides allow significantly higher accuracy of biopsies. The preliminary results are promising, but clinical evaluation is necessary.

scholarly journals A 3D printed cast for minimally invasive transfer of distal radius osteotomy: a cadaver study

2021 ◽  
Author(s):  
G. Caiti ◽  
J. G. G. Dobbe ◽  
S. D. Strackee ◽  
M. H. M. van Doesburg ◽  
G. J. Strijkers ◽  
...  
Keyword(s):  
Distal Radius ◽  
Corrective Osteotomy ◽  
Cadaver Study ◽  
Normal Weight ◽  
Patient Specific ◽  
Navigation Systems ◽  
Surgical Guides ◽  
Osteosynthesis Material ◽  
3D Printed ◽  
Guiding System

Abstract Purpose In corrective osteotomy of the distal radius, patient-specific 3D printed surgical guides or optical navigation systems are often used to navigate the surgical saw. The purpose of this cadaver study is to present and evaluate a novel cast-based guiding system to transfer the virtually planned corrective osteotomy of the distal radius. Methods We developed a cast-based guiding system composed of a cast featuring two drilling slots as well as an external cutting guide that was used to orient the surgical saw for osteotomy in the preoperatively planned position. The device was tested on five cadaver specimens with different body fat percentages. A repositioning experiment was performed to assess the precision of replacing an arm in the cast. Accuracy and precision of drilling and cutting using the proposed cast-based guiding system were evaluated using the same five cadaver arms. CT imaging was used to quantify the positioning errors in 3D. Results For normal-weight cadavers, the resulting total translation and rotation repositioning errors were ± 2 mm and ± 2°. Across the five performed surgeries, the median accuracy and Inter Quartile Ranges (IQR) of pre-operatively planned drilling trajectories were 4.3° (IQR = 2.4°) and 3.1 mm (IQR = 4.9 mm). Median rotational and translational errors in transferring the pre-operatively planned osteotomy plane were and 3.9° (IQR = 4.5°) and 2.6 mm (IQR = 4.2 mm), respectively. Conclusion For normal weight arm specimens, navigation of corrective osteotomy via a cast-based guide resulted in transfer errors comparable to those using invasive surgical guides. The promising positioning capabilities justify further investigating whether the method could ultimately be used in a clinical setting, which could especially be of interest when used with less invasive osteosynthesis material.

scholarly journals Hybrid Spine Simulator Prototype for X-ray Free Pedicle Screws Fixation Training

2021 ◽  
Vol 11 (3) ◽  
pp. 1038
Author(s):  
Sara Condino ◽  
Giuseppe Turini ◽  
Virginia Mamone ◽  
Paolo Domenico Parchi ◽  
Vincenzo Ferrari
Keyword(s):  
Augmented Reality ◽  
Low Cost ◽  
Lumbar Vertebrae ◽  
Pedicle Screws ◽  
Simulation Software ◽  
Patient Specific ◽  
Innovative Strategy ◽  
X Ray ◽  
3D Printed ◽  
Harmful Radiation

Simulation for surgical training is increasingly being considered a valuable addition to traditional teaching methods. 3D-printed physical simulators can be used for preoperative planning and rehearsal in spine surgery to improve surgical workflows and postoperative patient outcomes. This paper proposes an innovative strategy to build a hybrid simulation platform for training of pedicle screws fixation: the proposed method combines 3D-printed patient-specific spine models with augmented reality functionalities and virtual X-ray visualization, thus avoiding any exposure to harmful radiation during the simulation. Software functionalities are implemented by using a low-cost tracking strategy based on fiducial marker detection. Quantitative tests demonstrate the accuracy of the method to track the vertebral model and surgical tools, and to coherently visualize them in either the augmented reality or virtual fluoroscopic modalities. The obtained results encourage further research and clinical validation towards the use of the simulator as an effective tool for training in pedicle screws insertion in lumbar vertebrae.

scholarly journals Corrective Osteotomy of Upper Extremity Malunions Using Three-Dimensional Planning and Patient-Specific Surgical Guides: Recent Advances and Perspectives

2021 ◽  
Vol 8 ◽  
Author(s):  
Babak Saravi ◽  
Gernot Lang ◽  
Rebecca Steger ◽  
Andreas Vollmer ◽  
Jörn Zwingmann
Keyword(s):  
Range Of Motion ◽  
Upper Extremity ◽  
Therapeutic Approach ◽  
Corrective Osteotomy ◽  
Three Dimensional ◽  
Current Evidence ◽  
Patient Specific ◽  
Computer Assisted ◽  
Surgical Guides ◽  
Recent Advances

Malunions of the upper extremity can result in severe functional problems and increase the risk of osteoarthritis. The surgical reconstruction of complex malunions can be technically challenging. Recent advances in computer-assisted orthopedic surgery provide an innovative solution for complex three-dimensional (3-D) reconstructions. This study aims to evaluate the clinical applicability of 3-D computer-assisted planning and surgery for upper extremity malunions. Hence, we provide a summary of evidence on this topic and highlight recent advances in this field. Further, we provide a practical implementation of this therapeutic approach based on three cases of malunited forearm fractures treated with corrective osteotomy using preoperative three-dimensional simulation and patient-specific surgical guides. All three cases, one female (56 years old) and two males (18 and 26 years old), had painful restrictions in range of motion (ROM) due to forearm malunions and took part in clinical and radiologic assessments. Postoperative evaluation of patient outcomes showed a substantial increase in range of motion, reduction of preoperatively reported pain, and an overall improvement of patients' satisfaction. The therapeutic approach used in these cases resulted in an excellent anatomical and functional reconstruction and was assessed as precise, safe, and reliable. Based on current evidence and our results, the 3-D preoperative planning technique could be the new gold standard in the treatment of complex upper extremity malunions in the future.

scholarly journals 3D Printed Models Improve Surgical Planning for Correction of Severe Postburn Ankle Contracture With External Fixator

2020 ◽  
Author(s):  
Youbai Chen ◽  
Zehao Niu ◽  
Weiqian Jiang ◽  
Yonghong Lei ◽  
Lingli Guo ◽  
...  
Keyword(s):  
External Fixator ◽  
Surgical Planning ◽  
Outcome Variable ◽  
Patient Specific ◽  
Control Group ◽  
External Fixators ◽  
3D Printed ◽  
Operation Duration ◽  
Tract Infections

Abstract Background: Gradual distraction with external fixators such as Ilizarov frame has been widely used for the treatment of severe postburn ankle contracture (PAC). However, the application of external fixator is complex and conventional surgical planning based on 2D imaging is compromised due to a lack of spatial geometry and tactile feedback. The purpose of this study was to evaluate the surgical planning with patient-specific 3D-printed models (3DPM) for the treatment of PAC with external fixators. Methods: A two-centered retrospective cohort study, composed of consecutive patients who underwent external fixation for the treatment of severe PAC, was implemented. Patients were divided into two cohorts (3DPM group vs. Control group) according to whether 3DPM was used for preoperative surgical planning. The primary outcome variable was operation duration. Other outcome variables included improvement in metatarsal-tibial angle (MTA), range of motion (ROM), American Orthopedic Foot and Ankle Society (AOFAS) scores, and complications. Results: Between January 2008 and June 2018, ten patients with an average age of 23.8±14.1 yeas were treated for PAC at two centers. 3DPM were used for surgical planning in 5 patients. 3DPM group had significantly shorter operation duration than the control group (2±0.3 hours vs. 3.2±0.3 hours, p=0.0001). The comparison of preoperative, after removal of external fixator, and follow-up MTA, ROM, and AOFAS between the 3DPM and control group showed no significant differences. A plantigrade foot was achieved and gait was substantially improved in all patients at the final follow-up. Pin-tract infections occurred in 2 patients (one in each group) during distraction and were treated with wound care and oral antibiotics. Conclusion: The results of this study show that surgical planning using patient-specific 3DPM significantly reduced the operation duration while providing similar improvements in MTA, ROM, and AOFAS scores compared to traditional surgical planning for the correction of severe PAC with external fixators.

scholarly journals Augmented reality in computer‐assisted interventions based on patient‐specific 3D printed reference

2018 ◽  
Vol 5 (5) ◽  
pp. 162-166 ◽  
Author(s):  
Rafael Moreta‐Martinez ◽  
David García‐Mato ◽  
Mónica García‐Sevilla ◽  
Rubén Pérez‐Mañanes ◽  
José Calvo‐Haro ◽  
...  
Keyword(s):  
Augmented Reality ◽  
Patient Specific ◽  
Computer Assisted ◽  
3D Printed

scholarly journals Computer-Assisted Preoperative Simulations and 3D Printed Surgical Guides Enable Safe and Less-Invasive Mandibular Segmental Resection: Tailor-Made Mandibular Resection

2020 ◽  
Vol 10 (4) ◽  
pp. 1325
Author(s):  
Bo-Yeon Hwang ◽  
Jae-Yeol Lee ◽  
Junho Jung ◽  
Joo-Young Ohe ◽  
Young-Gyu Eun ◽  
...  
Keyword(s):  
Computer Assisted ◽  
Defect Classification ◽  
Anatomical Structures ◽  
Less Invasive ◽  
Surgical Guides ◽  
Invasive Method ◽  
3D Printed ◽  
Inferior Border ◽  
Bone Margin ◽  
Disease Free

This study aimed to present and evaluate alternative lesion-specific mandibulectomy methods for preserving the mandibular anatomical structures as compared with the conventional virtual surgical plan. Fifteen patients who received segmental mandibulectomy were included in this study, and the following parameters were evaluated: (1) the disease-free bone margin, (2) the volume and surface between the tailor-made resection simulation and conventional resection simulation, and (3) the preserved mandibular anatomical structures. In all 15 patients, disease-free bone margins were confirmed by histopathology. Volumes of conventional resection simulation and tail-made resection simulation were 49,468.66 ± 14,007.96 mm3 and 52,610.01 ± 13,755.33 mm3 and the surfaces were 20,927.38 ± 4471.70 mm2 and 22,356.49 ± 4185.73 mm2, respectively; these were statistically significant (both, p < 0.001). Mandibular dentition was partially preserved in six patients. Twelve of the 15 patients had changes in defect classification with preservation of the mandibular inferior border. In conclusion, alternative lesion-specific mandibulectomy was a less invasive method for effectively removing mandibular lesions while preserving the important anatomical structures of the mandible.

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