Search Results (3)

One of the most frequent bone deformities in dogs is antebrachial growth deformity (AGD), which results from malunion of the distal growth plates. The objective of the present study was to re-align the limbs, which can correct the length mismatch and reset the coherence of the joint with the aid of a 3-D phantom model for surgical preplanning. A 14-month-old, intact female Golden Retriever with an angular deformity of the left radius and ulna was selected for the study. The diagnosis was confirmed by orthogonal radiographs. Moreover, computed tomography (CT) scans revealed a multiplane deformity with valgus, procurator, and external rotation of the left radius. The pre-surgical planning started with the quantification of the angular deformity, followed by a simulated virtual osteotomy, and concluded with an in vitro rehearsal surgery on 3-D printed phantom bone models. In the operating room, prefabricated patient-specific instrumentation (PSI) was attached at the planned site of the radial bone surface for a precise closing wedge osteotomy. Then two locking plates were fixed routinely. Post-operative radiographs showed accurate correction of the deformity as we had planned. At 12 weeks post-operatively, the follow-up surveys revealed improved gait, weight-bearing, and progression of bone healing. Our PSI design, based on novel surgical planning, was steady yet straightforward during the osteotomy. The osteotomy was performed without difficulty since the PSI that pre-determined the sites and angles let the surgeon perform the antebrachial malformation surgery. This method of operation reduces stress on the operator and helps to improve accuracy, repeatability, and surgery time. Full article

3-D surgical planning for restorative osteotomy is costly and time-consuming because surgeons need to be helped from commercial companies to get 3-D printed bones. However, practitioners can save time and keep the cost to a minimum by utilizing free software and establishing their 3-D printers locally. Surgical planning for the corrective osteotomy of antebrachial growth deformities (AGD) is challenging for several reasons (the nature of the biapical or multiapical conformational abnormalities and lack of a reference value for the specific breed). Pre-operative planning challenges include: a definite description of the position of the center of rotation of angulation (CORA) and proper positioning of the osteotomies applicable to the CORA. In the present study, we demonstrated an accurate and reproducible bone-cutting technique using patient-specific instrumentations (PSI) 3-D technology. The results of the location precision showed that, by using PSIs, the surgeons were able to accurately replicate preoperative resection planning. PSI results also indicate that PSI technology provides a smaller standard deviation than the freehand method. PSI technology performed in the distal radial angular deformity may provide good cutting accuracy. In conclusion, the PSI technology may improve bone-cutting accuracy during corrective osteotomy by providing clinically acceptable margins. Full article

Ulnar lengthening has gained popularity in treating forearm deformity due to hereditary multiple exostoses (HME). Whether a simultaneous radius angular correction is necessary for bowing deformity remains debatable. We aimed to evaluate effectiveness and safety of ulnar lengthening alone in HME children. HME patients with forearm deformity who underwent ulnar lengthening between 2011 and 2016 were included. Patients were divided into two groups: eight juniors (age ≤ 10 years) and six seniors (>10 years). The mean age of two groups was 8.1 ± 2.5 and 16.7 ± 4.4 years, respectively. The juniors underwent ulnar lengthening alone, and the seniors received an additional radial corrective osteotomy. Pre-operative and post-operative parameters of supination, pronation, ulnar variance (UV), radial articular angles (RAA), and carpal slip (CS) were assessed. The juniors rather the seniors had an improvement in supination (p < 0.05 and p = 0.109, respectively). The juniors and seniors improved in pronation (p < 0.05). UV, RAA, and CS were corrected in the seniors (p < 0.05). In the juniors, parameters improved in UV, RAA, and CS (p < 0.05). For HME children, ulnar lengthening alone can restore radiologic anatomy and functions, providing comparable surgical outcomes in cosmetic results and clinical parameters. Full article