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.

Fractures of bones of the forearm are the most frequent damage of the bones of the upper limb. A high percentage of unsatisfactory results of the treatment necessitates research on the development of effective methods of medical rehabilitation. Purpose. To evaluate the effectiveness of tape kinesiology and hand trainers in the medical rehabilitation of patients with fractures of the forearm bones. Material and methods. 68 patients (22 men and 46 women) aged of 19-85 years with isolated fractures of the forearm bones were examined. In 65 patients, bone osteosynthesis was performed, external fixation devices were used in 3 patients. All patients were divided into three groups. All patients were divided into three groups. The 21 cases from the control group received standard medical rehabilitation. In 23 patients from the comparison group the standard medical rehabilitation was supplemented by standard kinesiology with standard medical rehabilitation. In 24 patients from the main group hand trainers were used against the background of standard medical rehabilitation and kinesiology. The effectiveness of the treatment was assessed on the basis of the VAS scale, the DASH and SF-36 questionnaires, the Green and O’Brien scoring scheme. Results. The complex application of tape kinesiology and hand trainers in comparison with standard medical rehabilitation and the use of tape kinesiology allows increase the amplitude of movements by 29,1% and 11,0%, rotational movements by 24,11% and 9,12%, to improve the DASH 46,8% and 19,6%; reduce the severity of the pain syndrome by 45,5% and 22,7%, diminish the number of patients with edema by 1,8 and 1,5 times, respectively. In the long-term period surpasses the effectiveness of using kinesiotherapy by the amplitude of movement by 7,9%, rotational movements by 13,4%, DASH by 8,9%, and quality of life by 11,7%. Conclusion. The comprehensive application of tape kinesiology and hand trainers allows significantly reduce the severity of the pain syndrome, contributes both to the cupping of the edema and the most complete restoration of the functions of the wrist joint, as well to the improvement of the quality of life of patients.

Background.Vascular bone graft transposition is the one of most effective method of nonunion fracture and bone defect treatment. However, the use of this technique is associated with some difficulties. One is the adjustment of recipient bed size and the graft. The other is the difficulty to reconstruct the alignment and length of bone. A promising method of preparing for the vascular bone graft transposition is virtual three-dimensional planning based on computed tomography data and three-dimensional printing templates.The aimwas to summarize our experience in the treatment of bone nonunion and defects with vascular bone autografts using tree-dimensional virtual planning and printing.Material and methods.We analyzed the treatment process and outcomes of 4 patients with limb bone nonunion and 6 patients with bone defects. In all cases, we used vascular bone grafts. Internal fixation of grafts was used in 7 cases, external fixation was used in 3 cases. At preparation stage in 4 cases, we used tree-dimensional virtual surgery planning and printing templates.Results.One case was diagnosed with bone graft necrosis caused by venous thrombosis. Consolidation was achieved in all patients; a late consolidation was observed in 2 cases. Hematoma in donor area was seen in 2 patients. When using three-dimensional virtual planning and tree-dimensional printing templates, the operation time was decreased by 1 hour 5 minutes. We identified two cases of poor reposition in the group without virtual planning. No poor reposition was observed in the cases where tree-dimensional planning was used.Conclusion.Vascularized bone grafts provide an effective method to treat bone defects and nonunion. But the planning of graft and recipient site sizes is associated with certain difficulties. Our preliminary results have shown that virtual three-dimensional planning and printing allow improving the precision of the surgical procedure and decreasing operative time.