A laboratory comparison of computer navigation and individualized guides for distal radius osteotomy.

TLDR: Compared to navigated DRO, individualized guides were easier to use, faster, and produced more precise correction of ulnar variance and radial inclination.

Abstract: This article presents the results of a multiuser, randomized laboratory trial comparing the accuracy and precision of image-based navigation against individualized guides for distal radius osteotomy (DRO). Six surgeons each performed four DROs using image-based navigation and four DROs using individualized guides in a laboratory setting with plastic phantom replicas of radii from patients who had received DRO as treatment for radial deformity. Time required and correction errors of ulnar variance, radial inclination, and volar tilt were measured. There were no statistically significant differences in the average correction errors. There was a statistically significant difference in the standard deviation of ulnar variance error (2.0 mm for navigation vs. 0.6 mm for guides). There was a statistically significant difference in the standard deviation of radial inclination error ( $$6.1^{\circ }$$ for navigation vs. $$1.4^{\circ }$$ for guides). There were statistically significant differences in the times required (705 s for navigation vs. 214 s for guides) and their standard deviations (144 s for navigation vs. 98 s for guides). Compared to navigated DRO, individualized guides were easier to use, faster, and produced more precise correction of ulnar variance and radial inclination. The combination of true three-dimensional planning, ease of use, and accurate and precise corrective guidance makes the individualized guide technique a promising approach for performing corrective osteotomy of the distal radius.