Case Summary:
Complex Ulna Reconstruction with Autograft
Complex Ulna Reconstruction with Autograft
Patient Diagnosis:
This patient required reconstruction of their ulna to restore it length and to restore the realtionship at the DRUJ. However, this was deemed to be complex given the presence of severe post-traumatic elbow arthropathy.
Planned Procedure/Approach:
The segmental bone loss of the ulna require autograft reconstruction. The surgical plan involved free fibula harvest with anastomosis to avoid issues of aseptic necrosis and non-union. The healthy contralateral forearm would be used as a guide for restoration and neutral ulna variance.
What Insight Surgery provided:
- Patient-specific 3D segmented models of both forearms and fibulas (challenging due to the state of the ulna as the bone was in 2 segments, however our engineer was able to segment into a normal configuration while maintaining the joints center of rotation at the elbow)
- Virtual surgical plan – vital information to allow the surgeon to plan cuts on the distal and proximal segments and use the distance between osteotomies and angle of cuts to define the cut from the fibula
- Surgical Cutting Guides
Outcome/Benefits:
- Assessing the vascular supply to the fibula had to be carried out intra-operatively, rendering true surgical guides inviable.
- Insight Surgery instead provided a custom cylinder of the right length and angles to help guide the surgeon in their cuts, allowing them to more accurately configure the reconstruction.
- The surgeon stated – “It went great…Very impressed with the guides”.