Evaluation of in-house, haptic assisted surgical planning for virtual reduction of complex mandibular fractures

Nilsson, Johanna; Nysjö, Fredrik; Nyström, Ingela; Kämpe, Johan; Thor, Andreas

doi:10.1007/s11548-021-02353-w

Cited by 12 publications

(13 citation statements)

References 20 publications

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“…It is also possible to manually reduce the bone fragments using more advanced interfaces such as haptic systems or virtual reality (VR) environments (Fornaro et al, 2007;Fornaro et al, 2010a;Schvartzman et al, 2014;Kovler et al, 2015;Girod et al, 2016;Choi and Schmutz, 2020;Nilsson et al, 2021). This has been shown to be especially helpful for training purposes of surgical procedures, since the surgeon performing the reduction gets realistic feedback (Schvartzman et al, 2014;Choi and Schmutz, 2020).…”

Section: Virtual Bone Fracture Reduction Planningmentioning

confidence: 99%

“…VSP is increasingly available to orthopedic surgeons (Yoshii et al, 2019a) and is routinely deployed in orthopedic surgery mostly for arthroplasties, deformity correction surgery, spinal fusion surgery, and fracture revision surgeries (Vetter et al, 2014;Székely et al, 2016;Takao et al, 2018a). Until recently, VSP has lagged behind in trauma cases, which are more time-critical (Nilsson et al, 2021).…”

Section: Introduction 1backgroundmentioning

confidence: 99%

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Computer-assisted preoperative planning of bone fracture fixation surgery: A state-of-the-art review

Moolenaar

Tümer

Checa

2022

Front. Bioeng. Biotechnol.

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Background: Bone fracture fixation surgery is one of the most commonly performed surgical procedures in the orthopedic field. However, fracture healing complications occur frequently, and the choice of the most optimal surgical approach often remains challenging. In the last years, computational tools have been developed with the aim to assist preoperative planning procedures of bone fracture fixation surgery.Objectives: The aims of this review are 1) to provide a comprehensive overview of the state-of-the-art in computer-assisted preoperative planning of bone fracture fixation surgery, 2) to assess the clinical feasibility of the existing virtual planning approaches, and 3) to assess their clinical efficacy in terms of clinical outcomes as compared to conventional planning methods.Methods: A literature search was performed in the MEDLINE-PubMed, Ovid-EMBASE, Ovid-EMCARE, Web of Science, and Cochrane libraries to identify articles reporting on the clinical use of computer-assisted preoperative planning of bone fracture fixation.Results: 79 articles were included to provide an overview of the state-of-the art in virtual planning. While patient-specific geometrical model construction, virtual bone fracture reduction, and virtual fixation planning are routinely applied in virtual planning, biomechanical analysis is rarely included in the planning framework. 21 of the included studies were used to assess the feasibility and efficacy of computer-assisted planning methods. The reported total mean planning duration ranged from 22 to 258 min in different studies. Computer-assisted planning resulted in reduced operation time (Standardized Mean Difference (SMD): -2.19; 95% Confidence Interval (CI): -2.87, -1.50), less blood loss (SMD: -1.99; 95% CI: -2.75, -1.24), decreased frequency of fluoroscopy (SMD: -2.18; 95% CI: -2.74, -1.61), shortened fracture healing times (SMD: -0.51; 95% CI: -0.97, -0.05) and less postoperative complications (Risk Ratio (RR): 0.64, 95% CI: 0.46, 0.90). No significant differences were found in hospitalization duration. Some studies reported improvements in reduction quality and functional outcomes but these results were not pooled for meta-analysis, since the reported outcome measures were too heterogeneous.Conclusion: Current computer-assisted planning approaches are feasible to be used in clinical practice and have been shown to improve clinical outcomes. Including biomechanical analysis into the framework has the potential to further improve clinical outcome.

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Section: Virtual Bone Fracture Reduction Planningmentioning

confidence: 99%

Section: Introduction 1backgroundmentioning

confidence: 99%

Computer-assisted preoperative planning of bone fracture fixation surgery: A state-of-the-art review

Moolenaar

Tümer

Checa

2022

Front. Bioeng. Biotechnol.

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show abstract

“…It is also possible to manually reduce the bone fragments using more advanced interfaces such as haptic systems or virtual reality (VR) environments (Fornaro et al, 2007(Fornaro et al, , 2010aSchvartzman et al, 2014;Kovler et al, 2015b;Girod et al, 2016;Choi and Schmutz, 2020;Nilsson et al, 2021). This has been shown to be especially helpful for training purposes of surgical procedures, since the surgeon performing the reduction gets realistic feedback (Schvartzman et al, 2014;Choi and Schmutz, 2020).…”

Section: Virtual Bone Fracture Reduction Planningmentioning

confidence: 99%

“…VSP is increasingly available to orthopedic surgeons (Yoshii et al, 2019a) and is routinely deployed in orthopedic surgery mostly for arthroplasties, deformity correction surgery, spinal fusion surgery, and fracture revision surgeries (Vetter et al, 2014;Székely et al, 2016a;Takao et al, 2018a). Until recently, VSP has lagged behind in trauma cases, which are more time-critical (Nilsson et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Computer-Assisted Preoperative Planning of Bone Fracture Fixation Surgery: A State-Of-The-Art Review

Moolenaar¹,

Tümer²,

Checa³

2022

Preprint

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Background Bone fracture fixation surgery is one of the most commonly performed surgical procedures in the orthopedic field. However, fracture healing complications occur frequently, and the choice of the most optimal surgical approach often remains challenging. In the last years, computational tools have been developed with the aim to assist preoperative planning procedures of bone fracture fixation surgery. Objectives The aims of this review are (1) to provide a comprehensive overview of the state-of-the-art in computer-assisted preoperative planning of bone fracture fixation surgery, (2) to assess the clinical feasibility of the existing virtual planning approaches, and (3) to assess their clinical efficacy in terms of clinical outcomes as compared to conventional planning methods. Methods A literature search was performed in the MEDLINE-PubMed, Ovid-EMBASE, Ovid-EMCARE, Web of Science, and Cochrane libraries to identify articles reporting on the clinical use of computer-assisted preoperative planning of bone fracture fixation. Results 79 articles were included to provide an overview of the state-of-the art in virtual planning. While patient-specific geometrical model construction, virtual bone fracture reduction, and virtual fixation planning are routinely applied in virtual planning, biomechanical analysis is rarely included in the planning framework. 21 of the included studies were used to assess the feasibility and efficacy of computer-assisted planning methods. The reported total mean planning duration ranged from 22 to 258 minutes in different studies. Computer-assisted planning resulted in reduced operation time (Standardized Mean Difference (SMD): -2.19; 95% Confidence Interval (CI): -2.87, -1.50), less blood loss (SMD: -1.99; 95% CI: -2.75, -1.24), decreased frequency of fluoroscopy (SMD: -2.18; 95% CI: -2.74, -1.61), shortened fracture healing times (SMD:-0.51; 95% CI: -0.97, -0.05) and less postoperative complications (Risk Ratio (RR): 0.64, 95% CI: 0.46, 0.90). No significant differences were found in hospitalization duration. Some studies reported improvements in reduction quality and functional outcomes but these results were not pooled for meta-analysis, since the reported outcome measures were too heterogeneous. Conclusions Current computer-assisted planning approaches are feasible to be used in clinical practice and have been shown to improve clinical outcomes. Including biomechanical analysis into the framework has the potential to further improve clinical outcome.

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“… 2 Virtual surgical planning (VSP) in complex cases can facilitate the workflow for cranio-maxillofacial surgeons. 3 With advancement in surgical planning and it being an increasingly used tool amongst cranio-maxillofacial surgeons, VSP is being implemented in areas such as orthognathic surgery, 4 reconstructive surgery 5 as well as surgery of fractures in the mandible and other parts of the facial skeleton. 6–8 …”

Section: Introductionmentioning

confidence: 99%

Haptic-Assisted Surgical Planning (HASP) in a Case of Bilateral Mandible Fracture

Moafi¹,

Nysjö²,

Kämpe³

et al. 2022

IMCRJ

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Restoring normal skeletal anatomy in patients with complex trauma to the mandible can be difficult, the difficulty often increasing with an edentulous mandible. This study describes a case of a displaced edentulous bilateral mandibular fracture, which was preoperatively planned with the in-house haptic-assisted surgery planning system (HASP). A model of the virtually restored mandible was 3D-printed at the hospital and a reconstruction plate was outlined beforehand with the printed mandible as a template and served as a guide during surgery. This case suggests HASP as a valuable preoperative tool in the planning phase when dealing with maxillofacial trauma cases. With the application of virtual planning, the authors could analyze the desired outcome and were further supported in surgery by the guidance of the reconstruction plate outlined on the restored model of the mandible.

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Evaluation of in-house, haptic assisted surgical planning for virtual reduction of complex mandibular fractures

Cited by 12 publications

References 20 publications

Computer-assisted preoperative planning of bone fracture fixation surgery: A state-of-the-art review

Computer-assisted preoperative planning of bone fracture fixation surgery: A state-of-the-art review

Computer-Assisted Preoperative Planning of Bone Fracture Fixation Surgery: A State-Of-The-Art Review

Haptic-Assisted Surgical Planning (HASP) in a Case of Bilateral Mandible Fracture

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