The purpose was to compare the accuracy of the method using 3D printing model with the method using picture archiving and communication system (PACS) images in high tibial osteotomy (HTO). This study analyzed 40 patients with varus deformity and medial osteoarthritis. From 2012 to 2016, patients underwent HTO using either 3D printing model (20 knees) or method based on a PACS image (20 knees). After obtaining the correction angle for the target point (62.5% point of the mediolateral tibial plateau width), in the 3D printing method, the wedge-shaped 3D-printed model was designed with the measured angle and osteotomy section and was produced by the 3D printer. The PACS method used preoperative radiographs to shift the weight bearing axis. The accuracy of the HTO and the proportion of acceptable range (62.5 ± 5%) at each method was compared using the full-length lower limb radiographs at the sixth postoperative week. The pre and postoperative posterior tibial slope angle was also compared at each method.Purpose
Materials and methods
Although gradual bone transport may permit the
restoration of large-diameter bones, complications are common owing
to the long duration of external fixation. In order to reduce such
complications, a new technique of bone transport involving the use
of an external fixator and a locking plate was devised for segmental
tibial bone defects. A total of ten patients (nine men, one woman) with a mean age
at operation of 40.4 years (16 to 64) underwent distraction osteogenesis
with a locking plate to treat previously infected post-traumatic
segmental tibial defects. The locking plate was fixed percutaneously
to bridge proximal and distal segments, and was followed by external fixation.
After docking, percutaneous screws were fixed at the transported
segment through plate holes. At the same time, bone grafting was
performed at the docking site with the external fixator removed. The mean defect size was 5.9 cm (3.8 to 9.3) and mean external
fixation index was
13.4 days/cm (11.8 to 19.5). In all cases, primary union of the
docking site and distraction callus was achieved, with an excellent
bony result. There was no recurrence of deep infection or osteomyelitis,
and with the exception of one patient with a pre-existing peroneal
nerve injury, all achieved an excellent or good functional result. With short external fixation times and low complication rates,
bone transport with a locking plate could be recommended for patients
with segmental tibial defects. Cite this article:
