Application of 3D technology and printing for femoral derotation osteotomy: case and technical report

Fiz, Nicolás; Delgado, Diego; Sánchez, Xabier; Sánchez, Pello; Bilbao, Ane Miren; Oraa, Jaime; Sánchez, Mikel

doi:10.21037/atm.2017.07.03

Cited by 21 publications

(14 citation statements)

References 10 publications

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“…Since 2000, the 3D printing technique has developed rapidly and is widely used in the manufacturing industry (10,11). The 3D printing technique has now been introduced into the medical and biomedical fields (12)(13)(14)(15) and has potential value in clinical practice (16)(17)(18)(19). 3D printed bone models are promisingly accurate in morphology (20), including the morphology of bone fractures.…”

Section: Introductionmentioning

confidence: 99%

The addition of 3D printed models to enhance the teaching and learning of bone spatial anatomy and fractures for undergraduate students: a randomized controlled study

Wu¹,

Wang²,

Wang³

et al. 2018

Ann. Transl. Med

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Background: Whether or not the addition of 3D (three-dimension) printed models can enhance the teaching and learning environment for undergraduate students in regard to bone spatial anatomy is still unknown. In this study, we investigated the use of 3D printed models versus radiographic images as a technique for the education of medical students about bone spatial anatomy and fractures. Methods: The computed tomography (CT) data from four patients, each with a different fracture type (one spinal fracture, one pelvic fracture, one upper limb fracture, and one lower limb fracture), were obtained, and 3D models of the fractures were printed. A total of 90 medical students were enrolled in the study and randomly divided into two groups as follows: a traditional radiographic image group (presented by PowerPoint) and a 3D printed model group (combined PowerPoint and 3D models). Each student answered 5 questions about one type of fracture and completed a visual analog scale of satisfaction (0-10 points). Results: No significant differences were found in the upper limb or lower limb test scores between the 3D printed model group and the traditional radiographic image group; however, the scores on the pelvis and spine test for the traditional radiographic image group were significantly lower than the scores for the 3D printed model group (P=0.000). No significant differences were found in the test-taking times for the upper limb or lower limb (P=0.603 and P=0.746, respectively) between the two groups; however, the test-taking times for the pelvis and spine in the traditional radiographic image group were significantly longer than those of the 3D printed model group (P=0.000 and P=0.002, respectively). Conclusions: The 3D printed model may improve medical students' understanding of bone spatial anatomy and fractures in some anatomically complex sites.

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Section: Introductionmentioning

confidence: 99%

The addition of 3D printed models to enhance the teaching and learning of bone spatial anatomy and fractures for undergraduate students: a randomized controlled study

Wu¹,

Wang²,

Wang³

et al. 2018

Ann. Transl. Med

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“…Therefore, with the relevant alteration of the mechanical axis with mal-angulation of the osteotomies demonstrated in this study, an accurate preoperative planning and probably the use of intraoperative navigations aids should be considered for such surgical procedures, to properly implement the preoperative planning into the intraoperative situation, and to prevent deviation of postoperative mechanical leg axis. One possible solution could be a preoperative 3D planning and the use of PSI, already described for femoral rotational osteotomies by Fiz et al [17]. In particular these considerations should be taken in account in cases with higher degrees of rotations, as well as in cases with supracondylar procedures.…”

Section: Discussionmentioning

confidence: 99%

“…Nonetheless, implementation of the preoperative planning into the surgical situation can be challenging, wherefore some deviation from the planning is likely in most cases. A possible remedy could be the use of patient specific instruments (PSI) [15,17]. However, PSI are not yet routinely used in such surgical procedures and they are not always available.…”

Section: Introductionmentioning

confidence: 99%

The impact of mal-angulated femoral rotational osteotomies on mechanical leg axis: a computer simulation model

Jud

Vlachopoulos

Häller

et al. 2020

BMC Musculoskelet Disord

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Background: Subtrochanteric or supracondylar femoral rotational osteotomies are established surgical treatments for femoral rotational deformities. Unintended change of the mechanical leg axis is an identified problem. Different attempts exist to plan a correct osteotomy plane, but implementation of the preoperative planning into the surgical situation can be challenging. Goal of this study was to identify the critical threshold of mal-angulation of the osteotomy plane and of femoral rotation that leads to a relevant deviation of the postoperative mechanical leg axis using a computer simulation approach. Methods: Three-dimensional (3D) surface models of the lower extremity of two patients (Model 1: 42°femoral antetorsion; Model 2: 6°femoral retrotorsion) were generated from computed tomography data. First, baseline subtrochanteric and supracondylar rotational osteotomies, perpendicular to the femoral mechanical axis were simulated. Afterwards, mal-angulated osteotomies in sagittal and frontal plane followed by different degrees of rotation were simulated and frontal mechanical axis was analyzed. Results: 400 mal-angulated osteotomies have been simulated. Mal-angulation of ±30°with 30°rotation showed maximum deviation from preoperative mechanical axis in subtrochanteric osteotomies (4.0°± 0.4°) and in supracondylar osteotomies (12.4°± 0.8°). Minimal mal-angulation of 15°in sagittal plane in subtrochanteric osteotomies and mal-angulation of 10°in sagittal plane in supracondylar osteotomies altered the mechanical axis by > 2°. Mal-angulation in sagittal plane showed higher deviations of the mechanical axis (up to 12.4°± 0.8°), than in frontal plane mal-angulation (up to 4.0°± 1.9°). Conclusion: A femoral rotational osteotomy, perpendicular to the femoral mechanical axis, has no considerable influence on the mechanical leg axis. However, mal-angulation of femoral rotational osteotomies showed relevant changes of the mechanical leg axis. In supracondylar respectively subtrochanteric procedures, mal-angulation of only 10°in combination with already 15°of femoral rotation respectively mal-angulation of 15°in combination with 30°of femoral rotation, can lead to a relevant postoperative mechanical leg axis deviation of more than 2°, wherefore these patients probably would benefit from the use of navigation aids.

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“…Few cases of femoral derotational osteotomy for patellofemoral instability are described in the literature; all of them are fixed with plates [29–33]. There are reports of successful cases of femoral derotational osteotomy, due to femoral fracture malunion, fixed with anterograde nails [34–36]. In this case report, a retrograde femoral nail was chosen for various reasons.…”

Section: Discussionmentioning

confidence: 99%

Retrograde Intramedullary Nail Fixation for Derotational Femoral Osteotomy for Recurrent Femoropatellar Instability

Barahona

Zamorano

Barrientos

et al. 2019

Case Reports in Orthopedics

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Axial alignment of the femur and tibia is often misdiagnosed in patients with patellofemoral stability problems. Femoral torsion is critical for patellofemoral biomechanics, so it must be evaluated in every patient before the plan of surgery is decided. This case describes a femoral derotational osteotomy due to excessive internal torsion of the femur fixed with a retrograde femoral nail. This type of fixation provides a biomechanical advantage compared to plates. At the two-year follow-up, the patient achieved excellent results, reaching a functional score of 91 points on the Lysholm scale. Derotational femoral osteotomy should be considered in patellofemoral pathology, and a retrograde femoral nail is a valid fixation method for this surgery.

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Application of 3D technology and printing for femoral derotation osteotomy: case and technical report

Cited by 21 publications

References 10 publications

The addition of 3D printed models to enhance the teaching and learning of bone spatial anatomy and fractures for undergraduate students: a randomized controlled study

The addition of 3D printed models to enhance the teaching and learning of bone spatial anatomy and fractures for undergraduate students: a randomized controlled study

The impact of mal-angulated femoral rotational osteotomies on mechanical leg axis: a computer simulation model

Retrograde Intramedullary Nail Fixation for Derotational Femoral Osteotomy for Recurrent Femoropatellar Instability

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