{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T06:21:43Z","timestamp":1789021303790,"version":"build-2803163510"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Journal of Bone and Joint Surgery"],"published-print":{"date-parts":[[2018,7,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Malunion is the most frequent complication seen after a fracture of the distal end of the radius. The primary aim of this study was to compare patient-reported outcome measures (PROMs) after corrective osteotomy for malunited distal radial fractures with and without 3-dimensional (3D) planning and use of patient-specific surgical guides.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>From September 2010 to May 2015, 40 adult patients with a symptomatic extra-articular malunited distal radial fracture were randomized to 3D computer-assisted planning or conventional 2-dimensional (2D) planning for corrective osteotomy. The primary outcome was the Disabilities of the Arm, Shoulder and Hand (DASH) score. Secondary outcomes included the Patient-Rated Wrist Evaluation (PRWE) score, pain and satisfaction scores, grip strength, and radiographic measurements at 3, 6, and 12 months postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From baseline to 12 months of follow-up, the reduction in the mean DASH score was \u221230.7 \u00b1 18.7 points for the 3D planning group compared with \u221220.1 \u00b1 17.8 points for 2D planning (p = 0.103). Secondary functional outcome by means of the PRWE resulted in a similar reduction of \u221234.4 \u00b1 22.9 points for the 3D planning group compared with \u221226.6 \u00b1 18.3 points for the 2D planning group (p = 0.226). There were no significant differences in pain, satisfaction, range of motion, and grip strength. Radiographic analysis showed significant differences in the mean residual volar angulation (by 3.3\u00b0; p = 0.04) and radial inclination (by 2.7\u00b0; p = 0.028) compared with the templated side, in favor of 3D planning and guidance. The duration of preoperative planning and surgery as well as complication rates were comparable.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Although there was a trend toward a minimal clinically important difference in PROMs in favor of 3D computer-assisted guidance for corrective osteotomy of extra-articular distal radial malunion, it did not attain significance because of (post hoc) insufficient power. Despite the challenge of feasibility, a trial of large magnitude is warranted to draw definitive conclusions regarding clinical advantages of this advanced, more expensive technology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level I<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.17.00544","type":"journal-article","created":{"date-parts":[[2018,7,19]],"date-time":"2018-07-19T16:21:19Z","timestamp":1532017279000},"page":"1191-1202","source":"Crossref","is-referenced-by-count":68,"title":["Three-Dimensional Compared with Two-Dimensional Preoperative Planning of Corrective Osteotomy for Extra-Articular Distal Radial Malunion"],"prefix":"10.2106","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0301-3512","authenticated-orcid":false,"given":"Geert A.","family":"Buijze","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Academic Medical Center, Amsterdam, the Netherlands"},{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0305-922X","authenticated-orcid":false,"given":"Natalie L.","family":"Leong","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6110-559X","authenticated-orcid":false,"given":"Filip","family":"Stockmans","sequence":"additional","affiliation":[{"name":"Handgroep Groeninge, AZ Groeninge, Kortrijk, Belgium"},{"name":"KU Leuven Campus Kortrijk, Kortrijk, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8025-4163","authenticated-orcid":false,"given":"Peter","family":"Axelsson","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Institute of Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6392-9982","authenticated-orcid":false,"given":"Rodrigo","family":"Moreno","sequence":"additional","affiliation":[{"name":"Christine M. Kleinert Institute for Hand and Microsurgery, Louisville, Kentucky"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2827-9456","authenticated-orcid":false,"given":"Allan","family":"Ibsen S\u00f6rensen","sequence":"additional","affiliation":[{"name":"Department of Hand Surgery, Institute of Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2846-7959","authenticated-orcid":false,"given":"Jesse B.","family":"Jupiter","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2018,7,18]]},"reference":[{"issue":"4","key":"bib1-20230810","doi-asserted-by":"crossref","first-page":"541","DOI":"10.1016\/S0749-0712(21)00771-X","article-title":"Treatment of malunion of the distal radius","volume":"3","author":"Amadio","year":"1987","journal-title":"Hand Clin."},{"issue":"5","key":"bib2-20230810","doi-asserted-by":"crossref","first-page":"916","DOI":"10.1053\/jhsu.2001.26662","article-title":"Assessment of complications of distal radius fractures and development of a complication checklist","volume":"26","author":"McKay","year":"2001","journal-title":"J Hand Surg Am."},{"issue":"4","key":"bib3-20230810","doi-asserted-by":"crossref","first-page":"613","DOI":"10.2106\/00004623-198062040-00016","article-title":"Complications of Colles\u2019 fractures","volume":"62","author":"Cooney","year":"1980","journal-title":"J Bone Joint Surg Am."},{"issue":"1","key":"bib4-20230810","doi-asserted-by":"crossref","first-page":"27","DOI":"10.5435\/00124635-200701000-00004","article-title":"Malunion of the distal radius","volume":"15","author":"Bushnell","year":"2007","journal-title":"J Am Acad Orthop Surg."},{"issue":"7","key":"bib5-20230810","first-page":"1503","article-title":"Corrective osteotomy for intra-articular malunion of the distal part of the radius","volume":"87","author":"Ring","year":"2005","journal-title":"J Bone Joint Surg Am."},{"key":"bib6-20230810","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1097\/01.blo.0000152442.66083.ff","article-title":"Treatment of the neglected distal radius fracture","volume":"431","author":"Ring","year":"2005","journal-title":"Clin Orthop Relat Res."},{"issue":"5","key":"bib7-20230810","doi-asserted-by":"crossref","first-page":"725","DOI":"10.1016\/j.jhsa.2007.02.003","article-title":"Osteoarthritis of the wrist","volume":"32","author":"Weiss","year":"2007","journal-title":"J Hand Surg Am."},{"key":"bib8-20230810","first-page":"203","article-title":"Complications following distal radial fractures","volume":"51","author":"Jupiter","year":"2002","journal-title":"Instr Course Lect."},{"key":"bib9-20230810","first-page":"187","article-title":"Complex fractures of the distal part of the humerus and associated complications","volume":"44","author":"Jupiter","year":"1995","journal-title":"Instr Course Lect."},{"issue":"4","key":"bib10-20230810","doi-asserted-by":"crossref","first-page":"635","DOI":"10.1302\/0301-620X.69B4.3611172","article-title":"Three years after Colles\u2019 fracture. 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