Jeuken R M, Hendrickx R P M, Schotanus M G M, Jansen E J
Department of Orthopedic Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, Netherlands; Department of Orthopedic Surgery, Zuyderland Medical Center, Heerlen-Sittard, Netherlands.
Department of Orthopedic Surgery, Zuyderland Medical Center, Heerlen-Sittard, Netherlands.
Orthop Traumatol Surg Res. 2017 Sep;103(5):783-790. doi: 10.1016/j.otsr.2017.03.017. Epub 2017 Apr 17.
In this case report, we describe a left-arm both-bone forearm fracture in a 15-year-old girl who fell off a swing. Conservative treatment with an above-elbow cast failed, resulting in a malunion with functional impairment. The pro- and supination were 90/0/10, respectively. The patient complained of difficulties performing daily activities. For this pediatric case, a corrective osteotomy was proposed using a CT-guided technique aiming for maximum anatomical and functional outcome. It was the first time this technique was used in our hospital.
A corrective osteotomy of the patient's left arm was performed using 3D printed templates to guide the osteotomy orientation. These templates were produced using specialized software in which CT images of her malunited left forearm were overlaid with the mirrored images of her healthy right forearm.
The postoperative CT-scan showed a near-anatomical reduction with close to 1° correction in all three planes, as compared to the preoperative planning. Three months after surgery, the patient had regained full function of her left forearm.
Although this was the first time this technique was used in our hospital, it resulted in excellent anatomical and functional outcomes making it a safe, reliable and precise treatment option that may be useful for even more complex corrections.
Level V.
在本病例报告中，我们描述了一名15岁女孩从秋千上跌落导致的左臂双骨折。采用肘上石膏保守治疗失败，导致畸形愈合并伴有功能障碍。旋前和旋后分别为90/0/10。患者抱怨日常活动困难。对于该儿科病例，建议采用CT引导技术进行截骨矫正术，以实现最大程度的解剖和功能恢复。这是该技术首次在我院使用。
使用3D打印模板引导截骨方向，对患者左臂进行截骨矫正术。这些模板是使用专门软件制作的，在该软件中，她畸形愈合的左前臂CT图像与健康右前臂的镜像图像重叠。
术后CT扫描显示，与术前规划相比，在所有三个平面上均实现了近乎解剖复位，矫正接近1°。术后三个月，患者左前臂功能完全恢复。
尽管这是该技术首次在我院使用，但它取得了出色的解剖和功能效果，使其成为一种安全、可靠且精确的治疗选择，甚至可能对更复杂的矫正手术也有用。
V级。
