de Muinck Keizer R J O, Lechner K M, Mulders M A M, Schep N W L, Eygendaal D, Goslings J C
Trauma Unit, G4-137, Department of Surgery, Academic Medical Center, PO-box 22660, 1100 DD, Amsterdam, The Netherlands.
Department of Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
Strategies Trauma Limb Reconstr. 2017 Aug;12(2):77-89. doi: 10.1007/s11751-017-0284-8. Epub 2017 Apr 25.
The purpose of this study was to summarize and evaluate results of three-dimensional (3D-) planned corrective osteotomies of malunited distal radius fractures. 3D-planning techniques provide the possibility to address 3D-deformity that conventional planning methods might not address. We systematically searched PubMed, EMBASE and the Cochrane library for studies that performed a 3D-planned corrective osteotomy on patients with a malunited distal radius fracture. Fifteen studies with a total of 68 patients were included in the analysis. In 96% of cases, the preoperatively present palmar tilt, radial inclination and ulnar variance showed statistically significant improvement postoperatively with restoration to within 5° or 2 mm of their normal values. Mean flexion-extension, pro-supination and grip strength showed statistically significant improvement (p < 0.05). Complications were reported in 11 out of 68 patients (16%). With the current advances in 3D printing technology, 3D-planned corrective osteotomies seem a promising technique in the treatment of complex distal radius malunions. Level of evidence IV Systematic review of case series, Level IV.
本研究的目的是总结和评估三维（3D）规划的桡骨远端骨折畸形愈合矫正截骨术的结果。3D规划技术提供了处理传统规划方法可能无法解决的三维畸形的可能性。我们系统地检索了PubMed、EMBASE和Cochrane图书馆，以查找对桡骨远端骨折畸形愈合患者进行3D规划矫正截骨术的研究。分析纳入了15项研究，共68例患者。在96%的病例中，术前存在的掌倾角、桡骨倾斜度和尺骨变异术后显示出统计学上的显著改善，恢复到正常数值的5°或2毫米范围内。平均屈伸、旋前-旋后和握力显示出统计学上的显著改善（p<0.05）。68例患者中有11例（16%）报告了并发症。随着当前3D打印技术的进步，3D规划矫正截骨术似乎是治疗复杂桡骨远端畸形愈合的一种有前景的技术。证据等级IV 病例系列的系统评价，证据等级IV。
