In younger and active patients corrective osteotomy
is the preferred treatment option to correct severe bone deformities,
because the function can be restored.
In younger and active patients corrective osteotomy is the preferred treatment option to correct bone deformities, because the function can be restored and the joint can be preserved. In practice, most bone deformities are multi-planar and three-dimensional which makes pre-operative planning and the surgery very challenging because the quantification of the malunion based on conventional X-rays or single CT slices is less accurate. Therefore, 3D pre-operative planning combined with patient-specific instruments has become the benchmark for complex deformity correction, permitting precise reconstruction of the anatomy.
As corrective osteotomies are specific to a patient and their pathology, profound technical and clinical experience are required to create a feasible 3D pre-operative plan yielding the optimal clinical outcome.
We offer the most comprehensive system for corrective osteotomies of the musculoskeletal system together with our clinical partner Balgrist CARD. Balgrist CARD is specialise in 3D planning & patient-specific instrumentation for complex orthopaedic surgeries; they have successfully planned and performed more than 300 corrective osteotomies using this technology.
MyOsteotomy is an innovate system combining CT/MRI-based 3D pre-operative planning with custom-made cutting, drilling, and reduction guides that help the surgeon to perform a highly accurate and controlled procedure. MyOsteotomy allows treatment of very complex osteotomies, such as triple extra-articular osteotomies or multi-fragment intra-articular osteotomies, which are extremely difficult (OR almost impossible) in a conventional setup.
The 3D pre-operative plan and patient-specific instruments are designed jointly by a surgeon and a CARD-team engineer. If desired, the treating surgeon can be involved in the creation of the surgical plan. Each case is verified by an experienced orthopaedic surgeon, ensuring a clinically feasible and optimal solution.
Lower arm (distal radius, radius/ulna shaft, proximal radius), hand (carpal bones, metarcarpal bones, phalanges), upper arm and shoulder (humerus, clavicle), lower limb (femur, pelvis, tibia, fibula), foot (talus, calcaneus, metatarsal bones, phalanges).
3D model of a pathological radius, reconstructed from CT. Correct definition of the mal-union requires contralateral bone.
Superimposing the pathological bone (orange) with the mirror image of the healthy contralateral radius (green) permits to quantify the malunion in all 6 degrees of freedom (3x translation, 1x rotation, and 2x angles).
The osteotomy plane (blue) is defined in the planning software to simulate the osteotomy. The bone is cut into two fragments (orange and light blue).
Reduction is simulated by aligning the distal fragment (light blue) with the mirror image of the contralateral bone (green).
Position and orientation of the implant are defined on the reduced bone fragments. The direction of the angle-stable locking screws is indicated by red cylinders.
The position of the angle-stable locking screws (red cylinders) on the pathological bone before reduction is calculated by reverse transformation of the distal fragment, including the screws, to its initial position. By doing so, a pre-reduction drilling guide can be constructed (grey) to be used in the surgery to pre-drill the screw holes before osteotomy.
Intra-operative images after fixation.
The position and orientation of the implant are defined on the reduced bone fragments. The direction of the angle-stable locking screws is indicated by red cylinders.