Anatomical reduction and precise internal fixation of intra-articular fractures of the distal radius with virtual X-ray and 3D printing

Abstract

To evaluate and precisely internal fix intra-articular distal radial fracture (IDRF) using the virtual X-ray and three-dimensional (3D) printing technologies. Twenty-one patients with IDRF were recruited, and the data from digital design group (DDG) and real surgery group (RSG) were collected and analyzed. In DDG, the data from thin-slice computed tomography scan, virtual X-ray measurement parameters, including volar tilt, palmar tilt, radius length (D1), ulnar variation (D2), locking plate position parameter (D3) and distance between key nail and joint surface (D4) were collected. The bone was virtually fixed with the locking plate, and the final model of radius with the screw was obtained by 3D printing. In RSG, the locking plate was precisely pre-bended and used in surgery. During the surgery, the key K-wire was accurately placed and the locking plate was adjusted with the aid of the U-shaped navigation arm. The C-arm was used to observe the positions of key K-wires and the locking plate, and the same above-mentioned parameters were measured intra-and post-operatively. The data from RSG and DDG were compared statistically by t test. This approach proved to be successful in all 21 patients, and none of the screws pierced through the wrist joint surface. All the measured parameters, including the volar tilt, palmar tilt, D1-4, in RSG were not significantly different from preoperative DDG data. Virtual X-ray measurement of anatomical reduction parameters and 3D printing can help the anatomical reduction and precise internal fixation by providing quantitative references, preoperatively, intraoperatively and postoperatively.

A modified intrafocal pinning technique with three-dimensional planning to facilitate volar plating in dorsally comminuted AO/OTA C2 and C3 distal radius fractures

“…In our study, 3D digital models of the distal radius fractures were reconstructed preoperatively to analyze the collapsed articular surface. The feasibility of CT-based virtual preoperative planning has been investigated in previous studies [18][19][20][21]. Compared with the traditional preoperative planning techniques using handwriting hardcopy radiographs along with tracing paper or simple measurements in the PACS, the CT-based 3D preoperative planning was proven to provide better understanding of fracture shape and displacement, especially in intra-articular fractures [22,23].…”

3D planning and patient specific instrumentation for intraarticular corrective osteotomy of trapeziometacarpal-, metacarpal and finger joints

“…Intra-articular fractures need to be corrected precisely with respect to the original joint anatomy, which otherwise is associated with pain and an inferior functional outcome [13]. Detailed quantification of the preoperative joint situation and the use of 3D patient-specific guides have shown to be helpful in various situations such as treatment of malunited fractures and complex situations in various joints [5,6,[14][15][16][17][18]. When involving the articular surface, residual intra-articular deformity is not well tolerated [19,20] and accurate reconstruction of joint congruency is of upmost importance.…”

Impresión 3D en Cirugía Ortopédica y Traumatología. Revisión sistemática de su aplicabilidad y estudio de los métodos de esterilización más adecuados para la utilización en quirófanos de las impresiones realizadas en el hospital.

“…Guías quirúrgicas a medida Reducción y osteosíntesis de fracturas de radio distal mediante planificación virtual, premoldeado de la placa y utilización de un dispositivo de fabricación local para la ayuda al posicionamiento de la placa 139 Adquisición de la imagen: TAC, 120 kV, 175 mA, pitch 0,5, grosor de corte 0,625mm Segmentación:…”