An important challenge of the osteotomy procedures, particularly in the case of large and complex corrections, is the fixation of the osteotomy site. The purpose of this study is to propose a practical and cost-effect methodology for the plate adapting problem of osteotomy surgery.
A novel patient-specific plate contouring methodology, based on rapid prototyping (RP) and multi-point forming (MPF) techniques, was developed and evaluated. In this methodology, a female mold is fabricated by RP, based on the geometry of the osteotomy site and estimation of the plate spring back. The mold is then used to configure a MPF die, which is then used for press forming of the factory-made locking plate. The applicability of the methodology was assessed in two case studies.
The results of implementing the methodology on a femoral and a tibial locking plate indicated very good conformity with the underlying bone, in both the frontal and sagittal planes. The surgical application of the pre-operatively contoured tibial plate facilitated the plate locating and screw inserting procedures, and provided a secure fixation for bone fragments.
The results are promising and provide a proof of concept for the feasibility and applicability of the proposed methodology in clinical practice, as a complementary to the existing surgical preplanning and patient-specific instrument preparations.
The advantageous features of RP and the MPF were used to provide a solution for the plate adapting problem of osteotomy surgery.
The collaboration of Dr Soheil Mehdipour, Akhtar Hospital, Tehran, Iran, in the clinical parts of this work is greatly appreciated. The technical support of Fanavarn Jarahyar Sharif Co., Tehran, Iran, and Osveh Asian Medical Instrument Co., Mashhad, Iran, is appreciated. This study was supported by the Technology Development Grant from Sharif University of Technology.
Conflict of interests: The authors have a pending patent (Ref No US 2018/0015524) on the mold-based adjustment approach of multi-point forming dies.
Gomari, B., Farahmand, F. and Farkhondeh, H. (2019), "A rapid prototyping-based methodology for patient-specific contouring of osteotomy plates", Rapid Prototyping Journal, Vol. 25 No. 5, pp. 888-894. https://doi.org/10.1108/RPJ-09-2018-0257
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