Journal
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
Volume 141, Issue 8, Pages 1425-1432Publisher
SPRINGER
DOI: 10.1007/s00402-021-03856-6
Keywords
Patient-specific instrument; PSI; Computer-assisted surgery; Intra-articular radius fracture; 3D printing
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Funding
- Universitat Zurich
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Computer-assisted and PSI navigated intraarticular radius fracture treatment is feasible, safe and accurate. The benefits of this method, however, do not outstand the additional effort.
Background Intra-articular fractures are associated with posttraumatic arthritis if inappropriately treated. Exact reduction of the joint congruency is the main factor to avoid the development of arthrosis. Aim of this study was to evaluate feasibility of computer-assisted surgical planning and 3D-printed patient-specific instrumentation (PSI) for treatment of distal intraarticular radius fractures. Method 7 Patients who suffered a distal intraarticular radius fracture were enrolled in this prospective case series. Preoperative CT-scan was recorded, whereupon a 3D model was computed for surgical planning and design of PSI for surgical navigation. Postoperative accuracy and joint congruency were assessed. Patients were followed-up 3, 6 and 12 months postoperatively. Results Mean follow-up was 16 months. Over all range of motion was restored and flexion, extension and pronation showed significant recovery, p < 0.05. Biggest intraarticular joint step-off and gap reduced from average 2.49 (+/- 1.04) to 0.8 mm (+/- 0.44), p < 0.05 and 6.12 mm (+/- 1.04) to 2.21 mm (+/- 1.16), p < 0.05. Average grip strength restored (3-16 months) from 20.33 kg (+/- 7.12) to 39.3 kg (+/- 19.55) p < 0.05, 100% of the healthy contralateral side. 3D-accuracy for guided fragments was 2.07 mm (+/- 0.64) and 8.59 degrees (+/- 2.9) and 2.33 mm (+/- 0.69) and 12.86 degrees (+/- 7.13), p > 0.05 for fragments reduced with ligamentotaxis. Conclusion Computer-assisted and PSI navigated intraarticular radius fracture treatment is feasible, safe and accurate. The benefits of this method, however, do not outstand the additional effort.
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