Three-Dimensional Corrective Osteotomy for Malunited Diaphyseal Forearm Fractures Using Custom-Made Surgical Guides Based on Computer Simulation.

Abstract

Three-dimensional corrective osteotomy with use of custom-made surgical guides based on computer simulation can provide a good outcome for patients with a malunited diaphyseal forearm fracture. Obtain CT data of both forearms, and create computer models of the bones from CT data. Evaluate the 3D deformity by comparing the affected bone with the mirror image of the contralateral, normal bone. Simulate the 3D corrective osteotomy on the basis of information obtained from the deformity evaluation. Design custom-made surgical guides to reproduce the preoperative simulation during the actual surgery. Manufacture custom-made surgical guides to reproduce the preoperative simulation during the actual surgery. Perform the osteotomy using the custom-made osteotomy guides and achieve anatomical correction using the reduction guides. In our series of twenty patients, the average radiographic deformity angle preoperatively was 21° (range, 12° to 35°) compared with that of the normal arm; this improved to 1° (range, 0° to 4°) postoperatively. IndicationsContraindicationsPitfalls & Challenges.