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Session: Medical Instruments - Surgery I
Session starts: Friday 25 January, 10:30
Presentation starts: 11:15
Room: Lecture room 557

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Johannes Dobbe (Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amstedam, The Netherlands)
Joy Vroemen (Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Amstedam, The Netherlands)
Simon Strackee (Plastic, Reconstructive and Hand Surgery, Academic Medical Center, University of Amsterdam, Amstedam, The Netherlands)
Geert Streekstra (Biomedical Engineering and Physics, Academic Medical Center, University of Amsterdam, Amstedam, The Netherlands)

Abstract:
A bone fracture may lead to malunion of bone segments, which gives discomfort to the patient and may lead to chronic pain, reduced function and finally to early osteoarthritis. A treatment option to realign the bone segments is a corrective osteotomy [1]. In this procedure the surgeon tries to improve alignment by cutting the bone at, or near, the fracture location and fixates the bone segments in an improved position, using a plate and screws. Three-dimensional positioning is very complex and difficult to plan, perform and evaluate using standard 2-D fluoroscopy imaging [2]. We present a new technique that uses preoperative 3-D imaging to plan positioning and to design a patient-tailored fixation plate that only fits in one way and realigns the bone segments as planned in six degrees of freedom. The method is evaluated for distal radius osteotomy using artificial bones and renders realignment highly accurate and very reproducible (derr < 1.2 ± 0.8 mm and φerr < 1.8 ± 2.1°). Besides using a patient-tailored plate for corrective distal radius osteotomy, the method may be of interest for corrective osteotomy of other long bones, mandibular reconstruction and clavicular reconstruction as well. In all of these cases the contralateral side can equally be used as reference for reconstruction of the affected side. Even if a healthy reference is missing, the surgeon can plan the position of one (distal) bone segment with respect to another (proximal) bone segment in a manual fashion, e.g., guided by surrounding anatomy. A patient-tailored plate can thus generally be used to fixate bone segments in a planned position. The patient-tailored plating technology is expected to have a great impact on future corrective osteotomy surgery. REFERENCES [1] M. W. Patton, “Distal Radius Malunion”, J Am Soc Surg Hand, 4(4):266-274, (2004). [2] D. Paley D Principles of Deformity Correction, 1st edn, Springer-Verlag, Berlin, Heidelberg, New York, 2005, ISBN 3-540-41665-X