Virtual Surgical Planning (VSP) is becoming an increasingly important means of improving skills acquisition, optimizing clinical outcomes, and promoting patient safety in orthopedics and traumatology. Pediatric Orthopedics (PO) often deals with the surgical treatment of congenital or acquired limbs and spine deformities during infancy. The objective is to restore function, improve aesthetics, and ensure proper residual growth of limbs and spine, using osteotomies, bone grafts, age-specific or custom-made hardware and implants. Three-dimensional (3D) digital models were generated from Computed Tomography (CT) scans, using free open-source software, and the surgery was planned and simulated starting from the 3D digital model. 3D printed sterilizable models were fabricated using a low-cost 3D printer, and animations of the operation were generated with the aim to accurately explain the operation to parents. All procedures were successfully planned using our VSP method and the 3D printed models were used during the operation, improving the understanding of the severely abnormal bony anatomy.Introduction and Objective
Materials and Methods
Posterolateral instability of the knee is difficult to diagnose and treat. It has been attributed to failure of ligament reconstruction and has been the cause of numerous knee operations. We present a small group of patients who complained of giving way of the knee and who had an increased range of external rotation of the tibia at 90 degrees knee flexion. The patients all had similar symptoms. We describe the standing apprehension test, which was positive in every case. Anterior subluxation of the lateral femoral condyle was detected manually in four patients and confirmed by radiography and MRI in one. The medial knee pain which is often associated with episodes of instability is probably due to stretching of the posteromedial soft tissues and perhaps the saphenous nerve.
