Department of Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Room No. L0-113-3, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Med Biol Eng Comput. 2013 Jul;51(7):791-7. doi: 10.1007/s11517-013-1049-2. Epub 2013 Mar 5.
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.
桡骨远端骨折后，骨段可能会以不理想的位置愈合。这种情况可能会导致手部功能下降、疼痛，最终发展为骨关节炎，有时需要进行矫正手术。最近的研究报告了计算机辅助 3-D 规划技术，其中镜像对侧未受影响的桡骨作为参考，用于规划矫正性桡骨远端截骨术前的位置。然而，双侧不对称性可能会在这种术前规划中引入长度误差，可以通过考虑尺骨的对称性来补偿。本文研究了一种方法，用于规划桡骨远端矫正性截骨术，同时使用描述桡骨和尺骨不对称性之间关系的线性回归模型来补偿双侧长度差异。该方法通过对 20 名健康个体的 CT 扫描进行定量评估，并通过对患有桡骨远端愈合不良的患者的 CT 扫描进行定性评估。改进后的规划方法将绝对长度偏差降低了两倍，并显著降低了定位变化，从 2.9±2.1 毫米降至 1.5±0.6 毫米。我们预计该方法对未来的 3-D 矫正性桡骨远端截骨术规划具有重要价值。
