Case Summary:
Distal Radius Surgical Cutting Guides
Distal Radius Surgical Cutting Guides
Patient Diagnosis:
This adolescent patient presented with a bilateral Madelung’s deformity of the wrists with limited range of motion and significant pain, predominantly in the left wrist. The deformity included a collapsed volar rim of the radius that increased the likelihood of subluxation and a positive ulna variance.
Planned Procedure/Approach:
Due to the rarity of the condition and complexity of the deformity, the surgical team considered two approaches: a simpler bi-planar osteotomy or a dome osteotomy. The dome osteotomy plan was subsequently discounted as the surgeons saw challenges in being able to lengthen the radius.
The surgeon requested a 3D reconstruction of the patient’s anatomy and patient-specific guides for the left radius that would facilitate the restoration of the distal radial surface and correct the ulna variance to better resemble healthy anatomy.
What Insight Surgery provided:
- 3D virtual and 3D printed patient-specific anatomical model
- Surgical Guide 1 – For use in doing a partial osteotomy of the volar rim in order to restore the distal aspect of the radius
- Surgical Guide 2 – For doing a torsional osteotomy / for lengthening corrections of the radius
- Surgical Guide 3 – A pre-drilling guide in order to aid the location of the plate
Outcome/Benefits:
- The 3D virtual and physical model of the patient’s anatomy provided the surgeons with enhanced planning capabilities for them to better understand the pathology of the wrist. It also allowed them to identify limitations in the proposed dome osteotomy approach.
- Overall, the surgery was a success and the surgical guides allowed for highly accurate osteotomies, and the digital surgical pre-plan facilitated a correct positioning of the plate onto the patient’s anatomy.