Sri-Utenchai Nithid, Pengrung Nachapan, Srikong Korakod, Puncreobutr Chedtha, Lohwongwatana Boonrat, Sa-Ngasoongsong Paphon
Department of Orthopedics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Biomechanic Research Center, Meticuly Co Ltd., Chulalongkorn University, Bangkok 10330, Thailand.
World J Orthop. 2021 May 18;12(5):338-345. doi: 10.5312/wjo.v12.i5.338.
Recently, medical three-dimensional printing technology (3DPT) has demonstrated potential benefits for the treatment of cubitus varus deformity (CVD) by improving accuracy of the osteotomy through the use of an osteotomy guide, with or without a patient-mated plate. Here, we present an interesting CVD case, involving a patient who was treated with corrective biplanar chevron osteotomy using an innovative customized osteotomy guide and a newly designed patient-matched monoblock crosslink plate created with 3DPT.
A 32-year-old female presented with a significant CVD from childhood injury. A computer simulation was processed using images from computerized tomography scans of both upper extremities. The biplanar chevron osteotomy was designed to create identical anatomy between the mirror image of the contralateral distal humerus and the osteotomized distal humerus. Next, the customized osteotomy guide and patient-matched monoblock crosslink plate were designed and printed. A simulation osteotomy was created for the real-sized bone model, and the operation was performed using the posterior paratricipital approach with k-wire positioning from the customized osteotomy guide as a predrilled hole for screw fixation to achieve immediate control of the reduction after osteotomy. Our method allowed for successful treatment of the CVD case, significantly improving the patient's radiographic and clinical outcomes, with satisfactory result.
3DPT-created patient-matched osteotomy guide and instrumentation provides accurate control during CVD correction.
最近，医学三维打印技术（3DPT）已显示出通过使用截骨导向器（无论是否配有患者匹配钢板）提高截骨准确性，从而在治疗肘内翻畸形（CVD）方面具有潜在益处。在此，我们展示一个有趣的CVD病例，该病例涉及一名患者，其接受了使用创新的定制截骨导向器和通过3DPT制作的新设计的患者匹配整体式交联钢板进行的双平面人字形截骨矫正治疗。
一名32岁女性因童年受伤导致严重CVD。利用双上肢计算机断层扫描图像进行了计算机模拟。双平面人字形截骨设计旨在使对侧肱骨远端的镜像与截骨后的肱骨远端之间形成相同的解剖结构。接下来，设计并打印了定制的截骨导向器和患者匹配的整体式交联钢板。为真实尺寸的骨模型创建了模拟截骨，并采用后旁正中入路，根据定制截骨导向器进行克氏针定位作为螺钉固定的预钻孔，以在截骨后立即控制复位。我们的方法成功治疗了该CVD病例，显著改善了患者的影像学和临床结果，效果令人满意。
3DPT制作的患者匹配截骨导向器和器械在CVD矫正过程中提供了精确控制。
