Computer-Assisted Techniques in Corrective Distal Radius Osteotomy Procedures

Malunion of the distal radius is a common complication following a distal radius fracture. The surgical treatment of a symptomatic distal radius malunion is a Corrective Osteotomy (CO) procedure aimed at the restoration of the anatomical alignment of the distal radius articular surface in the wrist joint. Traditional 2D imaging techniques in the management of malunion have demonstrated to be limited in pre-, intra-, and postoperative imaging and visualization of the bone architecture. Over the past decades, with the advent of 3D imaging techniques, innovations emerged in the field of preoperative planning, navigation and 3D printing. The aim of this paper is to review the existing literature and inform clinicians and biomedical engineers approaching the field about advantages, disadvantages and future perspectives of existing computer-assisted technology for CO. Collected studies agree on showing the efficacy of CT-based 3D virtual planning. Patient-specific 3D printed guides and implants are at the moment the most promising technology to transfer the preoperative plan to the patient. However, further biomechanical studies, larger clinical trials and a major exposure of the clinicians to 3D planning are needed to augment the feasibility of using these technologies in standard practice.