Supramalleolar Osteotomy – Case Study
BACKGROUND:
A patient with osteoarthritis in need of a supramalleolar osteotomy to improve mobility and quality of life.
OPERATIVE PLAN:
Assessment of the patients’ preoperative pathology was performed by analyzing their CBCT data in Bonelogic® Foot & Ankle module.
The medial distal tibial angle (MDTA) and the tibial lateral surface angle (TLSA) were 85.5° and 93.7°, respectively. A corrective supramalleolar osteotomy was planned using the Planning module of Bonelogic®.
The simulation predicted that using a 14 mm saw with 0.4 mm thickness to create a wedge opening (of 8.72° and 5 mm wide), 20 mm from the tibial plafond to a depth of 31 mm, would result in an increase in the MDTA of 9.0° and a reduction of TLSA of 2.8°.
A surgical guide was manufactured and used in accordance with these parameters:
| Key bone alignment analytics: | Preoperative | Virtual post-op |
|---|---|---|
| Medial Distal Tibial Angle (coronal) | 85.5° | 94.5° |
| Tibial Lateral Surface Angle (sagittal) | 93.7° | 90.9° |
| Surgical planning parameters: | |
|---|---|
| Saw width | 14.0 mm |
| Saw thickness | 0.4 mm |
| Cut distance from tibial plafond (at tibial center line) | 20 mm |
| Saw depth | 31.0 mm |
| Wedge opening angle | 8.7° |
| Wedge opening width | 5.0 mm |
Summary of the key parameters from the analysis of the patient data and surgical plan.
Computer aided design of the surgical guide based on the parameters of the surgical guide.
Left. Pre-operative condition. Right. Simulated post-operative outcome.
3D-printed pateint-specific guide based on the surgical plan performed in Disior® software.
Surgical guide in use in the operating room.
Disior®’s Bonelogic® medical imaging software, was built specifically to help clinicians make diagnoses and plan patient treatment. Bonelogic® anatomical modules take DICOMs from CT, CBCT or WBCT and generates accurate models and analytics that describe the relationships between bones, like those used in this case study. The new Planning module, allows you to use these diagnostics to plan precise and effective treatments, through the creation of numerical plans and 3D-printed surgical guides (via third parties).
If you’re interested in learning how Disior®‘s products can aid in your clinical practice, talk to one of our experts. In a 30 minute meeting we can talk through your current image analysis workflow and discuss what we can do to improve patient outcomes together.