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Master Thesis

Étude de l'utilisation des guides de coupe chirurgicaux sur mesure chez les enfants atteints de déformations osseuses de l'avant-bras

Abstract : Introduction: preoperative 3-dimensional planning and patient-specific surgical guides are increasingly used in the treatment of complex forearm deformities, secondary to trauma or congenital malformation. Our goal was to assess the accuracy and the potential benefits of such devices in the management of pediatric cases.
Material and methods: twenty-four children with forearm post-traumatic malunion or Madelung deformity were included. Fifteen of them benefited from conventional surgery (i.e., G- group) while the other 9 benefited from pre-operative 3-dimensional planning and patient-specific surgical guides (i.e., G+ group). Measurement of correction error value was performed in the G+ group using postoperative antero-posterior (AP) and profile radiographs. Complication rates, operating times, radiation exposure rates and clinical outcomes of the two groups were compared.
Results: average error of correction was 4.7° ± 4.1° (from 0.2° to 13.5°) in the AP and lateral views. Errors of correction were higher in Madelung deformities than in malunion cases, in both planes (p = 0.6). Surgery was significantly faster when using guides, with a mean difference of operating time of 42 minutes (p = .02). If mean total radiation doses were significantly higher in the G+ group than in the G- group (p < .0001), mean per-operative fluoroscopy doses were higher in the G- group than in the G+ group (p = .08). Complications rates were similar in both groups (i.e., 2 in each group). Improvements in ranges of motion and quality of life were significantly greater in the G+ group.
Conclusion: in children, 3-dimensional planning and patient-specific osteotomy guides allows to accurately correct complex forearm deformities. This technic seems to improve functional outcomes and while significantly reducing the operating time and intra-operative radiation exposure rates.
Document type :
Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03376492
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Submitted on : Wednesday, October 13, 2021 - 3:08:46 PM
Last modification on : Thursday, April 7, 2022 - 2:28:02 PM
Long-term archiving on: : Friday, January 14, 2022 - 7:17:35 PM

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Marie Benayoun. Étude de l'utilisation des guides de coupe chirurgicaux sur mesure chez les enfants atteints de déformations osseuses de l'avant-bras. Médecine humaine et pathologie. 2020. ⟨dumas-03376492⟩

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