From Simulation to Surgery: 3D Preoperative Planning of a Distal Tibial Osteotomy in Pediatric Orthopedics

3D preoperative planning of a distal tibial osteotomy showing the patient-specific cutting guide and

Postoperative simulation showing the corrected tibial alignment and final plate positioning.

Postoperative X-ray showing corrected alignment and plate fixation after distal tibial osteotomy.

Postoperative X-ray showing corrected alignment and plate fixation after distal tibial osteotomy

Preoperative planning is essential in pediatric orthopedic surgery, where each millimeter counts and growth potential must be preserved.

In a recent case managed by Dr. Clélia Thouement, pediatric orthopedic surgeon, a distal tibial opening wedge osteotomy was meticulously prepared using patient imaging data and 3D surgical planning.

The digital planning process made it possible to:

• Correct a tibial malalignment,

• Define the distal positioning of both the osteotomy and fixation plate to achieve an epiphysiodesis effect,

• Determine the optimal plate placement to reduce subcutaneous prominence,

• Calculate an opening of 0.57 cm, adjusted for a 1 mm saw blade thickness.

Based on this plan, a patient-specific cutting guide was designed to translate these parameters accurately to the operating room.

A Seamless Transition from Digital to Surgical

The guide ensured:

• Precise placement of K-wires,

• Guided bone cuts following the validated planes,

• Correct plate positioning as planned in the simulation.

  
  

This close collaboration between the surgeon and the 3D-Side design team allowed a perfect alignment between the virtual planning and the actual surgical execution, ensuring consistency and reliability throughout the process. We sincerely thank Dr. Clélia Thouement for her trust and collaboration throughout this planning process.