Three-Dimensional-Printed Patient-Specific Osteotomy Guides, Repositioning Guides and Titanium Plates for Acute Correction of Antebrachial Limb Deformities in Dogs
Darren Carwardine, Mark J. Gosling, Neil J. Burton, Ffion Lorraine O’Malley, Kevin Parsons
Abstract
OBJECTIVE: The aim of this study was to describe the use of patient-specific three-dimensional (3D)-printed osteotomy guides, repositioning guides and custom-printed titanium plates for acute correction of antebrachial limb deformities in four dogs. METHODS: Retrospective review of antebrachial limb deformities in small breed chondrodystrophic dogs that were surgically corrected using a closing wedge ostectomy of the radius at a predetermined site using patient-specific osteotomy guides. Reduction was achieved without the need for intraoperative measurements using patient-specific 3D-printed repositioning guides secured and manipulated using temporary Kirschner wire fixation. The ostectomy of the radius was stabilized with a patient-specific 3D-printed titanium plate. RESULTS: All limbs were corrected to within 3.5 degrees (standard deviation [SD]: 1 degree) and 7.5 degrees (SD: 3 degrees) of the pre-planned deformity correction in the frontal and sagittal planes, respectively. No complications were encountered. Owners completed a canine orthopaedic index survey at a median postoperative follow-up time of 19 months. Surgery eliminated the main presenting complaint of buckling over of the manus in all cases. CLINICAL SIGNIFICANCE: The 3D-printed osteotomy repositioning guides and titanium plates facilitated accurate acute correction of antebrachial deformities in this case series. The methodology described simplifies intraoperative surgical decision-making on limb position with good clinical outcomes seen in a small number of clinical cases.