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The influence of positioning printed surgical guides on postoperative Imhäuser osteotomy outcomes in adolescents with Slipped Capital Femoral Epiphysis

Muijen, E.A. and Rhebergen, A. and Twisk, P.A.J. and Verwijs, M.C. (2020) The influence of positioning printed surgical guides on postoperative Imhäuser osteotomy outcomes in adolescents with Slipped Capital Femoral Epiphysis.

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Abstract:Background: In patients with Slipped Capital Femoral Epiphysis (SCFE), an Imhäuser osteotomy can be performed using a surgical guide to improve the accuracy of the surgery. However, the usage of the surgical guide during this procedure does not acquire the desired postoperative outcome. This study aims to research the extent to which displacement of the surgical guide during an Imhäuser osteotomy can be responsible for the postoperative deviation relative to the preoperative planning in adolescents with SCFE. Methods: In this experimental study, the articular surface to trochanter distance (ATD), neckshaft angle (NSA) and medial proximal femoral angle (MPFA) were used as outcomes to quantify the femoral position. Data of four patients were acquired and the deviation between planning and the postoperative outcome was determined for each patient. Simulations of the Imhäuser osteotomy were performed with displaced positions of the surgical guide on the femur. The positions are translations of 3 and 6 mm in posterior-anterior and superior-inferior direction and rotations of 5 degrees counterclockwise and clockwise. Three-dimensional (3D) printed model experiments of two of the patients at the reference position were performed to verify the simulations. Results: The ranges of deviation in the displacement directions compared to the clinical range of deviation showed no significant difference, with a significance level of 0.05, for: anterior ATD (p= 0.693), anterior NSA (p= 0.270), anterior MPFA (p= 0.553), superior MPFA (p= 0.137), inferior MPFA (p= 0.109), counterclockwise ATD (p= 0.098), counterclockwise MPFA (p= 0.615), clockwise NSA (p= 0.076) and clockwise MPFA (p= 0.081). For all other displacement directions and parameters, a significant difference was observed compared to the clinical range of deviation. Conclusion: An anterior displacement might explain the clinical deviation, as the ranges of deviation anteriorly do not significantly differ from the clinical range for the ATD, NSA and MPFA.
Item Type:Essay (Bachelor)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Technical Medicine BSc (50033)
Link to this item:http://purl.utwente.nl/essays/81482
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