Department of Hand Surgery, Balgrist University Hospital, University of Zurich, 8008 Zurich, Switzerland.
Department of Plastic and Hand Surgery, Inselspital University Hospital Bern, University of Bern, 3007 Bern, Switzerland.
Medicina (Kaunas). 2022 May 30;58(6):744. doi: 10.3390/medicina58060744.
: Three-dimensional planning and guided osteotomy utilizing patient-specific instrumentation (PSI) with the contralateral side used as a reference have been proven as effective in the treatment of malunions following complex fractures of the distal radius. However, this approach has not yet been described in relation to fracture reduction of the distal radius. The aim of this study was to assess the technical and logistical feasibility of computer-assisted surgery in a clinical setting using PSI for fracture reduction and fixation. : Five patients with varied fracture patterns of the distal radius underwent operative treatment with using PSI. The first applied PSI guide allowed specific and accurate placement of Kirschner wires inside the multiple fragments, with subsequent concurrent reduction using a second guide. : Planning, printing of the guides, and operations were performed within 5.6 days on average (range of 1-10 days). All patients could be treated within a reasonable period of time, demonstrating good outcomes, and were able to return to work after a follow-up of three months. Mean wrist movements (°) were 58 (standard deviation (SD) 21) in flexion, 62 (SD 15) in extension, 73 (SD 4) in pronation and 74 (SD 10) in supination at a minimum follow-up of 6 months. : Three-dimensional planned osteosynthesis using PSI for treatment of distal radius fractures is feasible and facilitates reduction of multiple fracture fragments. However, higher costs must be taken into consideration for this treatment.
: 利用患者特异性器械（PSI）进行三维规划和引导截骨术，以对侧作为参考，已被证明可有效治疗桡骨远端复杂骨折后的畸形愈合。然而，这种方法尚未在桡骨远端骨折复位中描述。本研究旨在评估计算机辅助手术在临床环境中使用 PSI 进行骨折复位和固定的技术和后勤可行性。 : 5 名桡骨远端骨折患者采用 PSI 进行手术治疗。第一个应用的 PSI 导板允许将克氏针准确地放置在多个骨折块内，然后使用第二个导板同时进行复位。 : 规划、导板打印和手术平均在 5.6 天内完成（范围为 1-10 天）。所有患者都能在合理的时间内得到治疗，结果良好，并且在随访 3 个月后能够恢复工作。6 个月的最低随访时，平均腕关节活动度（°）为：屈曲 58°（标准差 21°），伸展 62°（标准差 15°），旋前 73°（标准差 4°），旋后 74°（标准差 10°）。 : 使用 PSI 进行桡骨远端骨折的三维计划骨合成是可行的，可以促进多个骨折块的复位。然而，这种治疗方法的成本更高，必须加以考虑。
