Take it personally Advances in custom instrumentation for corrective osteotomy of the radius

Malunion of the distal radius is a common complication following a distal radius fracture. The surgical treatment of symptomatic distal radius malunion is 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. In the last decades, several innovations took place in pre- and intra- operative computer-assisted surgical systems, thanks to the advances in medical image acquisition and processing. In the field of corrective distal radius osteotomy, one of the most successful innovations has been the introduction of 3D printed Patient Specific Instruments (PSI). In particular, it has been demonstrated that the combined use of 3D pre-operative planning and PSIs in corrective osteotomy of the radius is beneficial in terms of final surgical outcome. However, design methods and design criteria of PSIs have not yet been entirely explored. Therefore, in this thesis, we aimed to: Enhance our knowledge on the use of patient-specific guides, with a special focus on quantification of the positioning accuracy; design PSIs for minimally invasive procedures that are biomechanically optimized to promote bone-healing and improve the speed and user-friendliness of the workflow of PSIs design to render the overall approach less expensive.