Abstract
Three-dimensional computer-assisted preoperative planning, combined with patient-specific
surgical guides, has become an effective technique for treating complex extra- and
intraarticular bone malunions by corrective osteotomy. The feasibility and accuracy
of such a technique has not yet been evaluated for ankle deformities. Four surgical
cases of varying complexity and location were selected for evaluation. Three-dimensional
bone models of the affected and contralateral healthy lower limb were generated from
computed tomography scans. The preoperative planning software permitted quantification
of the deformity in 3 dimensions and subsequent simulation of reduction, yielding
a precise surgical plan. Patient-specific surgical guides were designed, manufactured,
and finally applied during surgery to reproduce the preoperative plan. Evaluation
of the postoperative computed tomography scans indicated adequate reduction accuracy
with residual translational and rotational errors of <3 mm and <6°, respectively.
Two patients required revision surgery owing to anterior osseous impingement or delayed
union of the osteotomy. All patients were satisfied with the postoperative course
and were pain free at a mean follow-up period of 2.5 (range 1 to 4) years. These promising
results require confirmation in a clinical study with a larger sample size.
Level of Clinical Evidence
Keywords
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Article info
Publication history
Published online: June 29, 2017
Footnotes
Financial Disclosure: None reported.
Conflict of Interest: None reported.
Identification
Copyright
© 2017 by the American College of Foot and Ankle Surgeons. All rights reserved.
