Past, present and future of distal radius corrective osteotomy: From 2D based reconstruction to 3D data-driven, patient specific care.

Corrective osteotomy for distal radius malunion has evolved from two-dimensional (2D) radiograph based planning and surgeon performed geometric analysis to advanced three-dimensional (3D) virtual surgical planning (VSP). Historically guided by predefined radiographic parameters, contemporary practice increasingly emphasizes symptom severity and patient-specific functional goals. CT-based 3D models, contralateral surface matching, and patient-specific guides and implants have improved the accuracy of deformity correction. However, greater anatomical precision does not automatically translate into superior functional outcomes. Future progress depends on standardized evaluation frameworks, multicenter data collection, and predictive models to determine the clinical value of virtual surgical planning (VSP) and patient-specific implants (PSI) in delivering individualized, cost-effective and function-oriented care across the entire treatment pathway.