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 two-dimensional 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 three-dimensional (3-D) imaging techniques, innovations have emerged in the field of preoperative planning, navigation, and 3-D 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 the computed-tomography-based 3-D virtual planning. Currently, patient-specific 3-D printed guides and implants are the most promising technology to transfer the preoperative plan to the patient. However, further biomechanical studies, larger clinical trials, and a major exposure of clinicians to 3-D planning are needed to augment the feasibility of using these technologies in standard practice.