3D planning and patient-specific surgical guides in forearm osteotomy in children: Radiographic accuracy and clinical morbidity - 22/04/21

Doi : 10.1016/j.otsr.2021.102925

Marie Benayoun ^a, Tristan Langlais ^a,^b,⁎ , Romain Laurent ^a, Malo Le Hanneur ^a, Raphaël Vialle ^a,^c, Manon Bachy ^a, Franck Fitoussi ^a,^c
^a Service de Chirurgie Orthopédique et Réparatrice de l’Enfant, Hôpital Armand-Trousseau, Sorbonne Université, 26, Avenue du Dr Arnold-Netter, 75012 Paris, France
^b Service de Chirurgie Orthopédique Pédiatrique, Hôpital des Enfants Purpan, Université de Toulouse, Toulouse, France
^c Département des Maladies Musculo-Squelettiques et Innovations Thérapeutiques, Sorbonne Université, Paris, France

^⁎Corresponding author at: Service de Chirurgie Orthopédique et Réparatrice de l’Enfant, Hôpital Armand-Trousseau, Sorbonne Université, 26, Avenue du Dr Arnold-Netter, 75012 Paris, France.Service de Chirurgie Orthopédique et Réparatrice de l’Enfant, Hôpital Armand-Trousseau, Sorbonne Université26, Avenue du Dr Arnold-NetterParis75012France

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Abstract

Introduction

Three-dimensional (3D) planning and patient-specific surgical guides are increasingly used in the treatment of skeletal deformities. The present study hypothesis was that they are reliable in forearm osteotomy in children, with low morbidity.

Material and methods

Twenty-there children with one or several osteotomies to correct forearm deformities were retrospectively included: 9 (20 osteotomies) with surgical guide (G+), and 14 (28 osteotomies) without (G-). Etiologies comprised 8 cases of Madelung disease (3G+, 5G−) and 15 of post-traumatic malunion (6G+, 9G−). Mean age at surgery was 14.8±1.9 years. The patient-specific 3D-printed polyamide guides were produced from 3D virtual models based on 3D CT reconstruction. Mean follow-up was 22.1±13.6 months.

Results

Mean correction error was 5.3°±4.1 and 4.2°±4.1 in the frontal and sagittal planes respectively in G+ (p=0.6). Surgery time was significantly shorter in G+, by a mean 42min (p=0.02). Mean total radiation dose (preoperative CT+intraoperative fluoroscopy) was significantly higher in G+ (p<0.0001). Complications rates were similar between groups. Improvement in PRWE score was significantly greater in G+.

Conclusion

The present preliminary results were encouraging. 3D planning and patient-specific surgical guides can be used in the treatment of forearm deformity in children.