{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,12]],"date-time":"2026-11-12T06:44:31Z","timestamp":1794465871307,"version":"4.9.1"},"reference-count":21,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T00:00:00Z","timestamp":1665187200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T00:00:00Z","timestamp":1665187200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100007210","name":"RWTH Aachen University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007210","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur J Med Res"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Corrective osteotomies of the upper extremities with patient-specific instruments (PSIs) are increasingly used. In this context, the concordance between planning and postoperative 3D radiographs as well as the association between 3D accuracy and clinical outcome has rarely been evaluated. In this pilot study, we aimed to investigate our clinical mid-term outcome and 3D accuracy as well as their possible correlation, including identifying aspects critical to reaching optimal correction results.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>From October 2018 to January 2020, we used PSIs for 12 corrective osteotomies of the upper extremity in 11 bones of 8 patients (congenital or posttraumatic deformities in 2 elbows, 3 forearms, 3 distal radii). In follow-up examination (10\u201325\u00a0months postoperatively), patient satisfaction, grip strength, ROM, VAS, and DASH were evaluated. Three-dimensional radiological accuracy was determined with 3D-reconstructed postoperative CT scans. With the software tool \u201cPart Comparison\u201d of Mimics<jats:sup>\u00ae<\/jats:sup> Innovation Suite Software\/Materialise, surface differences of pre-planned and postoperative 3D models were compared.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Compared to the preoperative situation pain and function were better at follow-up: The average VAS score significantly decreased from 6.5\u2009\u00b1\u20094.1\u00a0cm preoperatively to 2.3\u2009\u00b1\u20092.6\u00a0cm at the follow-up time point (<jats:italic>p<\/jats:italic>\u2009=\u20090.008). The average DASH score significantly improved, from 48.4\u2009\u00b1\u200930.9 to 27.0\u2009\u00b1\u200925.2 (<jats:italic>p<\/jats:italic>\u2009=\u20090.015). In the part comparison analysis \u201cplanned vs postoperative comparison\u201d, significantly more points in percent (=\u20093D accuracy) were in a \u22123\u00a0mm to 3\u00a0mm interval than in the \u201cpreoperative vs planned comparison\u201d (87.3\u2009\u00b1\u200913.8% vs 48.9\u2009\u00b1\u200916.6%, <jats:italic>p<\/jats:italic>\u2009=\u20090.004). After surgery, the maximum deviation value over all cases was 4.5\u2009\u00b1\u20091.1\u00a0mm, and the minimum deviation value was \u2212\u20094.5\u2009\u00b1\u20091.2\u00a0mm vs preoperatively 12.9\u2009\u00b1\u20096.2\u00a0mm (<jats:italic>p<\/jats:italic>\u2009=\u20090.004) and \u2212\u20097.2\u2009\u00b1\u20092.1\u00a0mm (<jats:italic>p<\/jats:italic>\u2009=\u20090.02), respectively. Clinically, in all cases with higher accuracy (&gt;\u200990%), an improvement of either DASH or VAS or both of &gt;\u200960% to the preoperative values occurred. There was a significant correlation between accuracy (%) and \u0394VAS (<jats:italic>p<\/jats:italic>\u2009=\u20090.004). There were no method-related complications.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Our data after PSI-based corrective osteotomy in complex deformities of the upper extremity in a limited number of cases indicate a positive correlation between 3D accuracy and clinical outcomes. Examination of 3D accuracy to analyse sources of error in the hole procedure from initial CT scan to end of surgery even in patients with not fully satisfactory clinical results is required for further development of the method to achieve optimal correction results with nearly 100% congruence between the planned and postoperative 3D bone position.<\/jats:p>\n                <jats:p><jats:italic>Trial registration<\/jats:italic> This retrospective study was registered in the Center for Translational &amp; Clinical Research Aachen (CTC-A) with the number 20-514 on November 20, 2021<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s40001-022-00830-9","type":"journal-article","created":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T21:02:22Z","timestamp":1665262942000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["3D accuracy and clinical outcomes of corrective osteotomies with patient-specific instruments in complex upper extremity deformities: an approach for investigation and correlation"],"prefix":"10.1186","volume":"27","author":[{"given":"Heide","family":"Delbr\u00fcck","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David Christian","family":"Weber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J\u00f6rg","family":"Eschweiler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Hildebrand","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,8]]},"reference":[{"key":"830_CR1","doi-asserted-by":"publisher","first-page":"504","DOI":"10.1097\/BPO.0000000000000673","volume":"37","author":"AS Bauer","year":"2017","unstructured":"Bauer AS, Storelli DAR, Sibbel SE, McCarroll HR, Lattanza LL. Preoperative computer simulation and patient-specific guides are safe and effective to correct forearm deformity in children. J Pediatr Orthop. 2017;37:504\u201310. https:\/\/doi.org\/10.1097\/BPO.0000000000000673.","journal-title":"J Pediatr Orthop"},{"key":"830_CR2","doi-asserted-by":"publisher","first-page":"2375","DOI":"10.2106\/JBJS.G.01299","volume":"90","author":"T Murase","year":"2008","unstructured":"Murase T, Oka K, Moritomo H, Goto A, Yoshikawa H, Sugamoto K. Three-dimensional corrective osteotomy of malunited fractures of the upper extremity with use of a computer simulation system. J Bone Joint Surg Am. 2008;90:2375\u201389. https:\/\/doi.org\/10.2106\/JBJS.G.01299.","journal-title":"J Bone Joint Surg Am"},{"key":"830_CR3","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.K.00829","volume":"94","author":"J Miyake","year":"2012","unstructured":"Miyake J, Murase T, Oka K, Moritomo H, Sugamoto K, Yoshikawa H. 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Positioning evaluation of corrective osteotomy for the malunited radius: 3-D CT versus 2-D radiographs. Orthopedics. 2013;36:e193\u20139. https:\/\/doi.org\/10.3928\/01477447-20130122-22.","journal-title":"Orthopedics"},{"key":"830_CR6","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1016\/j.jse.2014.08.020","volume":"24","author":"S Omori","year":"2015","unstructured":"Omori S, Murase T, Oka K, Kawanishi Y, Oura K, Tanaka H, Yoshikawa H. Postoperative accuracy analysis of three-dimensional corrective osteotomy for cubitus varus deformity with a custom-made surgical guide based on computer simulation. J Shoulder Elbow Surg. 2015;24:242\u20139. https:\/\/doi.org\/10.1016\/j.jse.2014.08.020.","journal-title":"J Shoulder Elbow Surg"},{"key":"830_CR7","doi-asserted-by":"publisher","first-page":"710","DOI":"10.2106\/JBJS.18.00765","volume":"101","author":"K Oka","year":"2019","unstructured":"Oka K, Tanaka H, Okada K, Sahara W, Myoui A, Yamada T, et al. 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L-101763-02 Materialise 3-matic Medical 16.0\u2014Reference Guide."}],"container-title":["European Journal of Medical Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40001-022-00830-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s40001-022-00830-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s40001-022-00830-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,8]],"date-time":"2022-10-08T21:24:11Z","timestamp":1665264251000},"score":1,"resource":{"primary":{"URL":"https:\/\/eurjmedres.biomedcentral.com\/articles\/10.1186\/s40001-022-00830-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,8]]},"references-count":21,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["830"],"URL":"https:\/\/doi.org\/10.1186\/s40001-022-00830-9","relation":{},"ISSN":["2047-783X"],"issn-type":[{"value":"2047-783X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,8]]},"assertion":[{"value":"12 May 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 September 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 October 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The ethical committee of the medical faculty of RWTH Aachen University approved the study (EK 007\/21). It provides independent advice following the rules of the World Medical Association in the Helsinki Declaration on Human Research in the 1996 version according to Somerset West, following national laws, regulations, and the ICH-GCP guideline in the currently valid version ().","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"197"}}