{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T19:09:49Z","timestamp":1788376189022,"version":"build-2803163510"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T00:00:00Z","timestamp":1717113600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100003848","name":"Industrial Technology Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003848","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["3D Print Med"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Ulnar shortening osteotomy (USO) has demonstrated good outcomes for patients with ulnar impaction syndrome. To minimize complications such as non-union, precise osteotomy and firm fixation are warranted. Despite various ulnar shortening systems have been developed, current technology does not meet all needs. A considerable portion of patients could not afford those designated USO systems. To tackle this challenge, our team reported successful results in standardized free-hand predrilled USO technique. However, it is still technical demanding and requires sufficient experience and confidence to excel. Therefore, our team designed an ulnar shortening system based on our free-hand technique principle, using metal additive manufacturing technology. The goal of this study is to describe the development process and report the performance of the system.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Utilizing metal additive manufacturing technology, our team developed an ulnar shortening system that requires minimal exposure, facilitates precise cutting, and allows for the easy placement of a 3.5\u00a0mm dynamic compression plate, available to patients at zero out-of-pocket cost. For performance testing, two surgeons with different levels of experience in ulnar shortening procedures were included: one fellow-trained hand and wrist surgeon and one senior resident. They performed ulnar shortening osteotomy (USO) using both the free-hand technique and the USO system-assisted technique on ulna sawbones, repeating each method three times. The recorded parameters included time-to-complete-osteotomy, total procedure time, chip diameter, shortening length, maximum residual gap, and deviation angle.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>For the hand and wrist fellow, with the USO system, the time-to-complete osteotomy was significantly reduced. (468.7\u2009\u00b1\u200963.6 to 260.0\u2009\u00b1\u20095\u00a0s, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Despite the preop goal was shortening 3\u00a0mm, the average shortening length was significantly larger in the free-hand group (5\u2009\u00b1\u20090.1; 3.2\u2009\u00b1\u20090.2\u00a0mm, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05). Both maximum residual gap and deviation angle reported no statistical difference between the two techniques for the hand surgeon. As for the senior resident, the maximum residual gap was significantly reduced, using the USO system (2.9\u2009\u00b1\u20090.8; 0.4\u2009\u00b1\u20090.4\u00a0mm, <jats:italic>p<\/jats:italic>\u2009=\u20090.02). Between two surgeons, significant larger maximum residual gap and deviation angle were noted on the senior resident doctor, in the free-hand technique group, but not in the USO system group.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>The developed USO system may serve as a valuable tool, aiding in reliable and precise cutting as well as fixation for patients undergoing ulnar shortening osteotomy with a 3.5\u00a0mm dynamic compression plate, even for less experienced surgeons. The entire process, from concept generation and sketching to creating the CAD file and final production, serves as a translatable reference for other surgical scenarios.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s41205-024-00220-3","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T10:03:43Z","timestamp":1717149823000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Enabling the design of surgical instruments for under-resourced patients through metal additive manufacturing: ulnar shortening osteotomy as an example"],"prefix":"10.1186","volume":"10","author":[{"given":"Kuan-Lin","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng-Yu","family":"Yin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui-Kuang","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi-Chao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Pan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,5,31]]},"reference":[{"key":"220_CR1","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1054\/jhsb.2000.0476","volume":"26","author":"LR Scheker","year":"2001","unstructured":"Scheker LR, Severo A. Ulnar shortening for the treatment of early post-traumatic osteoarthritis at the distal radioulnar joint. J Hand Surg Br. 2001;26:41\u20134. https:\/\/doi.org\/10.1054\/jhsb.2000.0476.","journal-title":"J Hand Surg Br"},{"key":"220_CR2","doi-asserted-by":"publisher","first-page":"295","DOI":"10.4055\/cios.2011.3.4.295","volume":"3","author":"GH Baek","year":"2011","unstructured":"Baek GH, Lee HJ, Gong HS, Rhee SH, Kim J, Kim KW, Kong BY, Oh WS. Long-term outcomes of ulnar shortening osteotomy for idiopathic ulnar impaction syndrome: at least 5-years follow-up. Clin Orthop Surg. 2011;3:295\u2013301. https:\/\/doi.org\/10.4055\/cios.2011.3.4.295.","journal-title":"Clin Orthop Surg"},{"key":"220_CR3","doi-asserted-by":"publisher","first-page":"535","DOI":"10.1007\/s11552-014-9727-6","volume":"10","author":"R Rajgopal","year":"2015","unstructured":"Rajgopal R, Roth J, King G, Faber K, Grewal R. Outcomes and complications of ulnar shortening osteotomy: an institutional review. 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