Corrective distal radius osteotomy: including bilateral differences in 3-D planning

• Published in: Medical & biological engineering & computing 2013-07, Vol.51 (7), p.791-797
• Main Authors: Dobbe, J. G. G., Vroemen, J. C., Strackee, S. D., Streekstra, G. J.
• Format: Article
• Language: English
• Subjects: Adult; Arthritis; Asymmetry; Biomedical and Life Sciences; Biomedical engineering; Biomedical Engineering and Bioengineering; Biomedicine; Bone surgery; Compensation; Computer Applications; Female; Fractures; Fractures, Malunited - pathology; Fractures, Malunited - surgery; Human Physiology; Humans; Imaging; Imaging, Three-Dimensional - methods; Medical imaging; Middle Aged; Models, Anatomic; Original Article; Osteoarthritis; Osteopathic medicine; Osteotomy; Radiology; Radius - pathology; Radius - surgery; Regression analysis; Reproducibility of Results; Skeletal system; Studies; Surgery; Symmetry
• ISSN: 0140-0118; 1741-0444
• DOI: 10.1007/s11517-013-1049-2

After a fracture of the distal radius, the bone segments may heal in a suboptimal position. This condition may lead to a reduced hand function, pain and finally osteoarthritis, sometimes requiring corrective surgery. Recent studies report computer-assisted 3-D planning techniques in which the mirrored contralateral unaffected radius serves as reference for planning the position of the distal radius before corrective osteotomy surgery. Bilateral asymmetry, however, may introduce length errors into this type of preoperative planning that can be compensated for by taking into account the concomitant ulnae asymmetry. This article investigates a method for planning a correction osteotomy of the distal radius, while compensating for bilateral length differences using a linear regression model that describes the relationship between radii and ulnae asymmetry. The method is evaluated quantitatively using CT scans of 20 healthy individuals, and qualitatively using CT scans of patients suffering from a malunion of the distal radius. The improved planning method reduces absolute length deviations by a factor of two and markedly reduces positioning variation, from 2.9 ± 2.1 to 1.5 ± 0.6 mm. We expect the method to be of great value for future 3-D planning of a corrective distal radius osteotomy.