Abstract text (incl. references and figure legends)
Case history, clinical findings, investigation and diagnosis: 57 year old woman, fell while riding a bike. Deformity of her left wrist was present. X ray diagnostics showed a C3.3 distal radius fracture with fairly proximal involvement. After preliminary reduction in anaesthesia, a CT scan for further preoperative planning was made. Operative treatment was indicated.
Preoperative planning: With the use of 3D technology for preoperative planning surgery plan was done. The main reasons were severe comminution and to see if osteosinthetic material we have will be of proper dimension for this fracture. After doing a 3D reconstruction in the software we first analysed the fracture and the necessary steps for the reduction. After doing a virtual reduction we printed a reduced 3D fracture model in 1:1 ratio. When we combined the model with the intended plate - 85 cm long distal radius volar plate, we could see that the length of the plate is appropriate and made sure, that the distal part of the long plate is not too wide for the patient"s bone.
Treatment: Patient was operated one week after the injury when swelling of soft tissues was acceptable. The operation went according to preoperative plan, with all the steps being done as planned virtually. No additional steps were necessary. After the operation the patient had protection splint for pain management. 3 weeks after the surgery physiotherapy started. Despite developing some signs of CRBS, the range of movement 5 months after the surgery was 25° of wrist flexion and 35°of extension with good pronation/supination. The fracture was radiographically healed in good position.
Comments:3D planning with the additional help of 1:1 printed model is a great tool when dealing with complex fractures It can shorten the time of surgery and eliminate unnecessary steps that would appear if the plan would not be thoroughly developed. 3D planning and printing is another step to safer and better surgery procedure.
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