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3D planning and patient specific instrumentation for intraarticular corrective osteotomy of trapeziometacarpal-, metacarpal and finger joints

Title: 3D planning and patient specific instrumentation for intraarticular corrective osteotomy of trapeziometacarpal-, metacarpal and finger joints
Authors: Kabelitz, Method; Furrer, Pascal Raffael; Hodel, Sandro; Canonica, Sandro; Schweizer, Andreas
Source: Kabelitz, Method; Furrer, Pascal Raffael; Hodel, Sandro; Canonica, Sandro; Schweizer, Andreas (2022). 3D planning and patient specific instrumentation for intraarticular corrective osteotomy of trapeziometacarpal-, metacarpal and finger joints. BMC Musculoskeletal Disorders, 23(1):965.
Publisher Information: BioMed Central
Publication Year: 2022
Collection: University of Zurich (UZH): ZORA (Zurich Open Repository and Archive
Subject Terms: Balgrist University Hospital; Swiss Spinal Cord Injury Center; 610 Medicine & health
Description: BACKGROUND Intra-articular malunions of the finger can lead to deformity and loss of function and can be treated with intra-articular corrective osteotomies. The aim of this study was to evaluate radiographic joint congruency, feasibility and functional outcome of three-dimensional (3D) printed patient-specific instrumentation (PSI) for corrective osteotomies at the trapeziometacarpal and finger joints. METHODS Computer-tomography (CT) scans were acquired preoperatively for standard 3D planning, which was followed by calculation of cutting planes and the design of individualized bone surface contact drilling, sawing and reposition guides. Follow-up CT scans and clinical examinations (range of motion, grip strength) were performed. Postoperative complications were documented and patient-reported outcome measurements were assessed (Single Assessment Numeric Evaluation (SANE) score, brief Michigan Hand Questionnaire (MHQ)). RESULTS Ten patients (mean age 28.4 ± 12.8,range 13.8-51.3) years) were included with a mean follow-up of 21 ± 18 (3-59) months including seven osteotomies at the trapeziometacarpal or metacarpophalangeal joints and three at the proximal interphalangeal joint (PIP). All radiographic follow-up examinations showed the planned correction with good joint congruency and regular osseous consolidation. At the latest follow-up, the range of motion (ROM) increased and the average grip strength recovered to the level of the contralateral side. No postoperative complication was detected. The mean SANE score improved from 44 ± 23 (0-70) to 82 ± 12 (60-90) after a mean of 72 ± 20 (44-114) months. The mean postoperative brief MHQ was 92 ± 8 (71-98). CONCLUSION The use of 3D PSI in treating intra-articular malunions at the trapeziometacarpal and finger joints restored articular congruency accurately. ROM and grip strength improved postoperatively comparable to the healthy contralateral side and patient-reported outcome measures improved after medium-term follow-up.
Document Type: article in journal/newspaper
File Description: application/pdf
Language: English
ISSN: 1471-2474
Relation: https://www.zora.uzh.ch/id/eprint/226860/1/2022_Kabelitz_3D_planning_and_patient_specifc_instrumentation_for_intraarticular_corrective_osteotomy_of_trapeziometacarpal_metacarpal_and_fnger_joints_BMCMD.pdf; info:pmid/36348352; urn:issn:1471-2474
Availability: https://www.zora.uzh.ch/id/eprint/226860/; https://www.zora.uzh.ch/id/eprint/226860/1/2022_Kabelitz_3D_planning_and_patient_specifc_instrumentation_for_intraarticular_corrective_osteotomy_of_trapeziometacarpal_metacarpal_and_fnger_joints_BMCMD.pdf
Rights: info:eu-repo/semantics/openAccess ; Creative Commons: Attribution 4.0 International (CC BY 4.0) ; http://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.7BAF3C38
Database: BASE