Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

Zhang, Yuan‐Wei; Xiao, Xin; Gao, Wen-Cheng; Xiao, Youping; Zhang, Suli; Ni, Wen-Yan; Deng, Liang

doi:10.1186/s13018-019-1403-7

Cited by 36 publications

(44 citation statements)

References 26 publications

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“…Then, the closed-wedge osteotomy was performed by cutting through a slit on the template and using the reduction guide to align the bone [15]. Since then, many researchers have tried to develop an individualized navigation template for the lateral closed-wedge osteotomy for the CVD [9,16,17] and showed the advantages of this technique with respect to determining the osteotomy angle, osteotomy plane, and rotational angle. In this study, we innovatively designed the customized osteotomy guide to place on the posterior surface of the distal humerus due to the need for a posterior slit for the biplanar Chevron osteotomy.…”

Section: Discussionmentioning

confidence: 99%

Using 3D Printing Technology for Corrective Biplanar Chevron Osteotomy with Customized Osteotomy Guide and Patient-Matched Monoblock Crosslink Plate in Treatment of Cubitus Varus Deformity: A Case Report and Technical Note

Sri-utenc

Pengrung

SrikonK

et al. 2020

Preprint

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Background Cubitus varus deformity (CVD), a common complication after a supracondylar fracture of the distal humerus, is usually treated with corrective osteotomy. However, due to the complex anatomy of the distal humerus, conventional osteotomy techniques are sometimes unreliable and can result in an inaccurate correction, residual deformity, and lateral condyle prominence. Recently, medial three-dimensional (3D) printing technology has demonstrated potential benefits for the treatment of CVD by improving the accuracy of the osteotomy through the use of an osteotomy guide with or without a patient-mated plate. This study aimed to present an interesting CVD case involving a patient who was treated with corrective biplanar Chevron osteotomy using an innovative customized osteotomy guide and a newly designed patient-matched monoblock crosslink plate created with 3D printing technology. Methods A computer simulation was processed using images from computerized tomography(CT) scans of both upper extremities. The biplanar Chevron osteotomy was designed to create identical anatomy between the mirror image of the contralateral distal humerus and the osteotomized distal humerus. Next, the customized osteotomy guide and patient-matched monoblock crosslink plate were designed and printed. A simulation osteotomy for the real-sized bone model was created. Results The operation was performed using the posterior paratricipital approach and the k-wire position from the customized osteotomy guide as a predrilled hole for screw fixation to achieve immediate control of the reduction after osteotomy. Our method helped successfully treat the CVD in the case study patient and significantly improved her radiographic and clinical outcomes with a satisfactory result. Conclusion This study showed that the treatment of CVD using 3D printing technology to create an innovative customized osteotomy guide and a patient-matched monoblock crosslink plate can help accurately assess and control the CVD correction. To the best of our knowledge, this case report introduces a new insight for the clinical application of 3D printing technology in the treatment of CVD.

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Section: Discussionmentioning

confidence: 99%

Using 3D Printing Technology for Corrective Biplanar Chevron Osteotomy with Customized Osteotomy Guide and Patient-Matched Monoblock Crosslink Plate in Treatment of Cubitus Varus Deformity: A Case Report and Technical Note

Sri-utenc

Pengrung

SrikonK

et al. 2020

Preprint

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“…It had been reported that preoperative 3D models can help surgeons plan operations, assist young doctors in learning surgical methods, and enhance communication between patients and surgeons ( Liu et al, 2020 ). Moreover, preoperative 3D printed models, surgical guide plates, and customized implants in orthopedic clinical application exhibited significant advantage, including the individual customization, rapid manufacturing, and efficient intraoperative drilling and osteotomy ( Zhang et al, 2019a , b ; Dong et al, 2020 ). In present study, assisted 3D printed model showed the focus of thoracic tuberculosis and the destruction of vertebral bodies directly, which could enhance the comprehension of spinal tuberculosis and the necessity of surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical Evaluation and the Assisted 3D Printed Model in the Patient-Specific Preoperative Planning for Thoracic Spinal Tuberculosis: A Finite Element Analysis

Wang

Hua

et al. 2020

Front. Bioeng. Biotechnol.

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Posterior fixation is superior to anterior fixation in the correction of kyphosis and maintenance of spinal stability for the treatment of thoracic spinal tuberculosis. However, the process of selecting the appropriate spinal fixation method remains controversial, and preoperative biomechanical evaluation has not yet been investigated. In this study, we aimed to analyze the application of the assisted finite element analysis (FEA) and the three-dimensional (3D) printed model for the patient-specific preoperative planning of thoracic spinal tuberculosis. An adult patient with thoracic spinal tuberculosis was included. A finite element model of the T7−T11 thoracic spine segments was reconstructed to analyze the biomechanical effect of four different operative constructs. The von Mises stress values of the implants in the vertical axial load and flexion and extension conditions under a 400-N vertical axial pre-load and a 10-N⋅m moment were calculated and compared. A 3D printed model was used to describe and elucidate the patient’s condition and simulate the optimal surgical design. According to the biomechanical evaluation, the patient-specific preoperative surgical design was prepared for implementation. The anterior column, which was reconstructed with titanium alloy mesh and a bone graft with posterior fixation using seven pedicle screws (M+P) and performed at the T7–T11 level, decreased the von Mises stress placed on the right rod, T7 pedicle screw, and T11 pedicle. Moreover, the M+P evaded the left T9 screw without load bearing. The 3D printed model and preoperative surgical simulation enhanced the understanding of the patient’s condition and facilitated patient-specific preoperative planning. Good clinical results, including no complication of implants, negligible loss of the Cobb angle, and good bone fusion, were achieved using the M+P surgical design. In conclusion, M+P was recommended as the optimal method for preoperative planning since it enabled the preservation of the normal vertebra and prevented unnecessary internal fixation. Our study indicated that FEA and the assisted 3D printed model are tools that could be extremely useful and effective in the patient-specific preoperative planning for thoracic spinal tuberculosis, which can facilitate preoperative surgical simulation and biomechanical evaluation, as well as improve the understanding of the patient’s condition.

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“…Although 3D printing assisted guide plates have been diffusely applied in clinical correction researches of cubitus varus deformity, developmental dysplasia of the hip, spinal scoliosis, hallux valgus and other deformities [17][18][19][20], while the application in ATE malformation correction has been rarely reported. Previously, Windisch et al [21] applied 3D printing technology to fabricate a physical model of ATE malformation with a magnification of 4 times for surgeons to accurately analyze all bone and joint deformities, and perform preoperative planning, but this application only played the most basic role of 3D printing.…”

Section: Discussionmentioning

confidence: 99%

Clinical assessment of three-dimensional printing assisted osteotomy guide plates in precise osteotomy of adult talipes equinovarus

Zhang

Xiong²,

Huang

et al. 2020

Preprint

Self Cite

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Objectives: This current research is aimed to assess clinical efficacy and prognosis of three-dimensional (3D) printing assisted osteotomy guide plate in precise osteotomy of adult talipes equinovarus (ATE). Materials and Methods: We included a total of 27 patients of ATE malformation (including 12 males and 15 females) from January 2014 to June 2018 in current research. The patients were divided into the routine group (n=12) and 3D printing group (n=15) based on different operative methods. The parameters, including the operative time, intraoperative blood loss, complications, time to obtain bony fusion, functional outcomes based on American Orthopedic Foot and Ankle Society (AOFAS) and International Congenital Clubfoot Study group (ICFSG) scoring systems between the two groups were observed and recorded regularly. Results: The 3D printing group exhibits superiorities in shorter operative time, less intraoperative blood loss, higher rate of excellent and good outcomes presented by ICFSG score at last follow-up (P< 0.001, P< 0.001, P =0.019) than the routine group. However, there was no significant difference exhibited in AOFAS score at last follow-up and total rate of complications between the two groups (P=0.136, P =0.291). Conclusions: Operation assisted by 3D printing osteotomy guide plates for correcting the ATE malformation is novel and feasible, which might be an effective method to polish up the precise osteotomy of ATE malformation and enhance the clinical efficacy.

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Efficacy evaluation of three-dimensional printing assisted osteotomy guide plate in accurate osteotomy of adolescent cubitus varus deformity

Cited by 36 publications

References 26 publications

Using 3D Printing Technology for Corrective Biplanar Chevron Osteotomy with Customized Osteotomy Guide and Patient-Matched Monoblock Crosslink Plate in Treatment of Cubitus Varus Deformity: A Case Report and Technical Note

Using 3D Printing Technology for Corrective Biplanar Chevron Osteotomy with Customized Osteotomy Guide and Patient-Matched Monoblock Crosslink Plate in Treatment of Cubitus Varus Deformity: A Case Report and Technical Note

Biomechanical Evaluation and the Assisted 3D Printed Model in the Patient-Specific Preoperative Planning for Thoracic Spinal Tuberculosis: A Finite Element Analysis

Clinical assessment of three-dimensional printing assisted osteotomy guide plates in precise osteotomy of adult talipes equinovarus

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