{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T19:11:59Z","timestamp":1788981119831,"version":"build-2803163510"},"reference-count":33,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Perioper Med"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n Distal radius malunions occur in 5% to 17% of fractures and may lead to pain and functional impairment. While 3D surgical planning with patient-specific guides has demonstrated high accuracy and reduced fluoroscopy use compared with conventional 2D techniques, its routine clinical implementation remains limited, particularly for in-house hospital-based workflows.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to evaluate the precision of corrective osteotomy for distal radius malunions using in-house\u2013designed 3D patient-specific surgical guides 1 year after surgery. Secondary objectives were to assess clinical and patient-reported outcomes and document intraoperative fluoroscopy use.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Corrective osteotomies of extra-articular distal radius malunions were performed in 16 consecutive patients using in-house 3D surgical planning and patient-specific surgical guides. Accuracy was evaluated by comparing preoperative plans with 1-year postoperative computed tomography\u2013based 3D models, assessing ulnar variance, volar tilt, and radial inclination. Acceptable error margins were defined as 5\u00b0 or less for volar tilt and 2 mm or less for ulnar variance. Clinical outcomes were evaluated using patient-reported outcome measures and range of motion, lift, grip, and torque strength measurements.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n The mean absolute error was 1 (SD 0.8) mm in ulnar variance, 4.9\u00b0 (SD 2.7\u00b0) in volar tilt, and 1.9\u00b0 (SD 3.6\u00b0) in radial inclination. The corrections were within predefined equivalence bounds of the virtual plans in terms of ulnar variance but not volar tilt. Significant improvements were observed in Patient-Rated Wrist Evaluation (PRWE) and Disabilities of the Arm, Shoulder, and Hand (DASH) scores; pain during activity; pain at rest; lift strength; wrist flexion; and ulnar deviation. In total, 12.5% (2\/16) of the patients experienced complications following concomitant ulnar shortening procedures and were transferred to standard care. The median intraoperative fluoroscopy duration was 56 (IQR 26\u201072) seconds.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n In-house 3D planning was feasible and associated with generally favorable radiological and clinical outcomes at 1 year. However, the predefined equivalence criterion was not achieved for volar tilt, and the findings should be interpreted considering the small sample size and observed complications. In-house 3D planning supports continuous surgical refinement and quality improvement.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/101764","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:51:19Z","timestamp":1788979879000},"page":"e101764-e101764","source":"Crossref","is-referenced-by-count":0,"title":["In-House 3D Planning for Corrective Osteotomy of the Distal Radius: Prospective Cohort Study With 1-Year Radiological and Clinical Follow-Up"],"prefix":"10.2196","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8481-7935","authenticated-orcid":false,"given":"Charlotte","family":"Stor Swinkels","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2318-6824","authenticated-orcid":false,"given":"Peter","family":"Axelsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4030-106X","authenticated-orcid":false,"given":"Katleen","family":"Libberecht","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9753-8787","authenticated-orcid":false,"given":"Per","family":"Fredrikson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7912-2232","authenticated-orcid":false,"given":"Emilia","family":"Gryska","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0600-1365","authenticated-orcid":false,"given":"Anders","family":"Bj\u00f6rkman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2026,9,9]]},"reference":[{"key":"R1","unstructured":"The Swedish Fracture Register [Article in Swedish]. Svenska Frakturregistret. URL: https:\/\/sfr.registercentrum.se\/in-english\/the-swedish-fracture-register\/p\/HyEtC7VJ4 [Accessed 28-08-2026]"},{"issue":"3","key":"R2","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1177\/17531934231193849","article-title":"Distal radial fractures: a nationwide register study on corrective osteotomies after malunion","volume":"49","author":"Raudasoja","journal-title":"J Hand Surg Eur Vol"},{"issue":"3","key":"R3","doi-asserted-by":"publisher","first-page":"392","DOI":"10.1016\/0363-5023(91)90003-t","article-title":"Minor axial shortening of the radius affects outcome of Colles\u2019 fracture treatment","volume":"16","author":"Aro","journal-title":"J Hand Surg Am"},{"issue":"4","key":"R4","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1302\/0301-620X.70B4.3403617","article-title":"Colles fracture: does the anatomical result affect the final function?","volume":"70","author":"McQueen","journal-title":"J Bone Joint Surg Br"},{"issue":"1","key":"R5","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1054\/jhsb.2001.0693","article-title":"Outcome after corrective osteotomy for malunited fractures of the distal end of the radius","volume":"27","author":"Prommersberger","journal-title":"J Hand Surg Br"},{"issue":"14","key":"R6","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.2106\/JBJS.17.00544","article-title":"Three-dimensional compared with two-dimensional preoperative planning of corrective osteotomy for extra-articular distal radial malunion: a multicenter randomized controlled trial","volume":"100","author":"Buijze","journal-title":"J Bone Joint Surg Am"},{"issue":"9","key":"R7","doi-asserted-by":"publisher","DOI":"10.1016\/j.heliyon.2024.e29570","article-title":"Forearm rotation improves after corrective osteotomy in patients with symptomatic distal radius malunion","volume":"10","author":"van Es","journal-title":"Heliyon"},{"issue":"2","key":"R8","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1080\/2000656X.2019.1693392","article-title":"Long-term outcomes of corrective osteotomy for malunited fractures of the distal radius","volume":"54","author":"Andreasson","journal-title":"J Plast Surg Hand Surg"},{"issue":"6","key":"R9","doi-asserted-by":"publisher","first-page":"447","DOI":"10.1016\/j.jhsa.2017.03.024","article-title":"Conventional versus computer-assisted corrective osteotomy of the forearm: a retrospective analysis of 56 consecutive cases","volume":"42","author":"Bauer","journal-title":"J Hand Surg Am"},{"issue":"4","key":"R10","doi-asserted-by":"publisher","first-page":"713","DOI":"10.1007\/s11548-013-0966-8","article-title":"A laboratory comparison of computer navigation and individualized guides for distal radius osteotomy","volume":"9","author":"Ma","journal-title":"Int J Comput Assist Radiol Surg"},{"issue":"1","key":"R11","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-018-2279-0","article-title":"Improving accuracy of opening-wedge osteotomies of distal radius using a patient-specific ramp-guide technique","volume":"19","author":"Roner","journal-title":"BMC Musculoskelet Disord"},{"issue":"6","key":"R12","doi-asserted-by":"publisher","first-page":"102925","DOI":"10.1016\/j.otsr.2021.102925","article-title":"3D planning and patient-specific surgical guides in forearm osteotomy in children: radiographic accuracy and clinical morbidity","volume":"108","author":"Benayoun","journal-title":"Orthop Traumatol Surg Res"},{"issue":"1","key":"R13","doi-asserted-by":"publisher","first-page":"85","DOI":"10.1007\/s00776-010-0020-4","article-title":"Accuracy of corrective osteotomy using a custom-designed device based on a novel computer simulation system","volume":"16","author":"Oka","journal-title":"J Orthop Sci"},{"issue":"2","key":"R14","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1007\/s11751-017-0284-8","article-title":"Three-dimensional virtual planning of corrective osteotomies of distal radius malunions: a systematic review and meta-analysis","volume":"12","author":"de Muinck Keizer","journal-title":"Strategies Trauma Limb Reconstr"},{"issue":"6","key":"R15","doi-asserted-by":"publisher","first-page":"1766","DOI":"10.1007\/s11999-010-1748-z","article-title":"Distal radius osteotomy with volar locking plates based on computer simulation","volume":"469","author":"Miyake","journal-title":"Clin Orthop Relat Res"},{"issue":"12","key":"R16","doi-asserted-by":"publisher","first-page":"2339","DOI":"10.1016\/j.jhsa.2013.09.023","article-title":"Three-dimensional correction of distal radius intra-articular malunions using patient-specific drill guides","volume":"38","author":"Schweizer","journal-title":"J Hand Surg Am"},{"issue":"4","key":"R17","doi-asserted-by":"publisher","first-page":"306","DOI":"10.1055\/s-0033-1359307","article-title":"Accuracy of 3D virtual planning of corrective osteotomies of the distal radius","volume":"2","author":"Stockmans","journal-title":"J Wrist Surg"},{"issue":"1","key":"R18","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-97788-5","article-title":"Preclinical paired noninferiority study comparing in-house and commercially available 3D planning for corrective osteotomy of the distal radius","volume":"15","author":"Stor Swinkels","journal-title":"Sci Rep"},{"issue":"5","key":"R19","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1007\/s00402-012-1466-y","article-title":"Malunion of the distal radius","volume":"132","author":"Prommersberger","journal-title":"Arch Orthop Trauma Surg"},{"key":"R20","doi-asserted-by":"publisher","DOI":"10.2340\/jphs.v59.39839","article-title":"Improving standard volar plate fixation in 3D-guided corrective osteotomy of the distal radius: evaluation of a shim instrument","volume":"59","author":"Gryska","journal-title":"J Plast Surg Hand Surg"},{"issue":"4","key":"R21","doi-asserted-by":"publisher","first-page":"365","DOI":"10.1177\/1753193416641590","article-title":"Why and how to report surgeons\u2019 levels of expertise","volume":"41","author":"Tang","journal-title":"J Hand Surg Eur Vol"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000223994.79894.17","article-title":"Corrective osteotomies in malunions of the distal radius: do we get what we planned?","volume":"450","author":"von Campe","journal-title":"Clin Orthop Relat Res"},{"issue":"8","key":"R23","doi-asserted-by":"publisher","first-page":"710","DOI":"10.1016\/j.jhsa.2018.05.003","article-title":"Association between radiological and patient-reported outcome in adults with a displaced distal radius fracture: a systematic review and meta-analysis","volume":"43","author":"Mulders","journal-title":"J Hand Surg Am"},{"issue":"15","key":"R24","doi-asserted-by":"publisher","first-page":"1156","DOI":"10.2106\/JBJS.22.01096","article-title":"Association between radiographic and clinical outcomes following distal radial fractures: a prospective cohort study with 1-year follow-up in 366 patients","volume":"105","author":"Schmidt","journal-title":"J Bone Joint Surg Am"},{"issue":"6","key":"R25","doi-asserted-by":"publisher","first-page":"602","DOI":"10.1002\/(SICI)1097-0274(199606)29:6<602::AID-AJIM4>3.0.CO;2-L","article-title":"Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG)","volume":"29","author":"Hudak","journal-title":"Am J Ind Med"},{"issue":"1","key":"R26","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1197\/j.jht.2003.10.003","article-title":"Responsiveness of the Disability of the Arm, Shoulder, and Hand (DASH) and Patient-Rated Wrist\/Hand Evaluation (PRWHE) in evaluating change after hand therapy","volume":"17","author":"MacDermid","journal-title":"J Hand Ther"},{"key":"R27","unstructured":"Manual f\u00f6r r\u00f6relse- och styrkem\u00e4tning av armb\u00e5ge, underarm och hand. HAKIR; 2026. URL: https:\/\/rcsyd.se\/hakir\/wp-content\/uploads\/sites\/23\/2026\/03\/HAKIR-matmanual-2026-1.pdf [Accessed 01-09-2026]"},{"issue":"9","key":"R28","doi-asserted-by":"publisher","first-page":"865.e1","DOI":"10.1016\/j.jhsa.2018.01.009","article-title":"New methods to assess forearm torque and lifting strength: reliability and validity","volume":"43","author":"Axelsson","journal-title":"J Hand Surg Am"},{"key":"R29","doi-asserted-by":"publisher","DOI":"10.1097\/01.blo.0000205891.96575.0f","article-title":"Current concepts in volar fixed-angle fixation of unstable distal radius fractures","volume":"445","author":"Orbay","journal-title":"Clin Orthop Relat Res"},{"issue":"2","key":"R30","doi-asserted-by":"publisher","first-page":"e193","DOI":"10.3928\/01477447-20130122-22","article-title":"Positioning evaluation of corrective osteotomy for the malunited radius: 3-D CT versus 2-D radiographs","volume":"36","author":"Vroemen","journal-title":"Orthopedics"},{"issue":"1","key":"R31","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.otsr.2017.11.012","article-title":"Application of 3D-printing technology in the treatment of humeral intercondylar fractures","volume":"104","author":"Zheng","journal-title":"Orthop Traumatol Surg Res"},{"issue":"5","key":"R32","doi-asserted-by":"publisher","first-page":"385","DOI":"10.1080\/08941939.2017.1339150","article-title":"Treatment of die-punch fractures with 3D printing technology","volume":"31","author":"Chen","journal-title":"J Invest Surg"},{"issue":"10","key":"R33","doi-asserted-by":"publisher","first-page":"3235","DOI":"10.1007\/s11999-015-4376-9","article-title":"The minimum clinically important difference of the patient-rated wrist evaluation score for patients with distal radius fractures","volume":"473","author":"Walenkamp","journal-title":"Clin Orthop Relat Res"}],"container-title":["JMIR Perioperative Medicine"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T18:51:21Z","timestamp":1788979881000},"score":1,"resource":{"primary":{"URL":"https:\/\/periop.jmir.org\/2026\/1\/e101764"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,9]]},"references-count":33,"URL":"https:\/\/doi.org\/10.2196\/101764","relation":{},"ISSN":["2561-9128"],"issn-type":[{"value":"2561-9128","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,9]]},"article-number":"v9i3e101764"}}