Bauer David Ephraim, Zimmermann Stefan, Aichmair Alexander, Hingsammer Andreas, Schweizer Andreas, Nagy Ladislav, Fürnstahl Philipp
Orthopedic Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
Orthopedic Department, Balgrist University Hospital, University of Zurich, Zurich, Switzerland.
J Hand Surg Am. 2017 Jun;42(6):447-455. doi: 10.1016/j.jhsa.2017.03.024. Epub 2017 Apr 20.
Accuracy and feasibility of corrective osteotomies using 3-dimensional planning tools and patient-specific instrumentation has been reported by multiple authors with promising results. However, studies describing clinical outcomes following these procedures are rare. Therefore, the purpose of this study was to compare the results of computer-assisted corrective osteotomies of the diaphyseal and distal radius with a conventional non-computer-assisted technique regarding duration of surgery, consolidation of the osteotomy, and complications. Also, subjective and objective clinical outcome parameters were assessed.
We retrospectively compared the results of 31 patients who underwent a corrective osteotomy performed conventionally with 25 patients treated with a computer-assisted method (CA) using patient-specific instrumentation. Baseline data were similar among both groups. The duration of surgery, bony consolidation, complications, gain in range of motion, and subjective outcome were recorded.
The mean operating time was significantly shorter in the CA group compared with the conventional group. After 12 weeks, significantly more osteotomies were considered healed in the CA group compared with the conventional group. Two patients in the CA group required revision surgery to treat nonunion of the osteotomy. Otherwise clinical results were similar among both groups.
The results demonstrate that the computer-assisted method facilitates shorter operation times while providing similar clinical results.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
多位作者报道了使用三维规划工具和患者特异性器械进行截骨矫正术的准确性和可行性，结果令人满意。然而，描述这些手术后临床结果的研究很少。因此，本研究的目的是比较计算机辅助桡骨干和桡骨远端截骨矫正术与传统非计算机辅助技术在手术时间、截骨愈合情况和并发症方面的结果。此外，还评估了主观和客观的临床结果参数。
我们回顾性比较了31例行传统截骨矫正术的患者与25例采用患者特异性器械的计算机辅助方法（CA）治疗的患者的结果。两组的基线数据相似。记录手术时间、骨愈合情况、并发症、活动范围增加情况和主观结果。
与传统组相比，CA组的平均手术时间明显更短。12周后，与传统组相比，CA组中更多的截骨被认为已愈合。CA组有2例患者需要翻修手术来治疗截骨不愈合。除此之外，两组的临床结果相似。
结果表明，计算机辅助方法在提供相似临床结果的同时，有助于缩短手术时间。
研究类型/证据水平：治疗性IV级。
