Reproducibility of three dimensional digital preoperative planning for the osteosynthesis of distal radius fractures

Abstract

A three-dimensional (3D) digital preoperative planning system for the osteosynthesis of distal radius fractures was developed for clinical practice. To assess the usefulness of the 3D planning for osteosynthesis, we evaluated the reproducibility of the reduction shapes and selected implants in the patients with distal radius fractures. Twenty wrists of 20 distal radius fracture patients who underwent osteosynthesis using volar locking plates were evaluated. The 3D preoperative planning was performed prior to each surgery. Four surgeons conducted the surgeries. The surgeons performed the reduction and the placement of the plate while comparing images between the preoperative plan and fluoroscopy. Preoperative planning and postoperative reductions were compared by measuring volar tilt and radial inclination of the 3D images. Intra-class correlation coefficients (ICCs) of the volar tilt and radial inclination were evaluated. For the implant choices, the ICCs for the screw lengths between the preoperative plan and the actual choices were evaluated. The ICCs were 0.644 (p < 0.01) and 0.625 (p < 0.01) for the volar tilt and radial inclination in the 3D measurements, respectively. The planned size of plate was used in all of the patients. The ICC for the screw length between preoperative planning and actual choice was 0.860 (p < 0.01). Good reproducibility for the reduction shape and excellent reproducibility for the implant choices were achieved using 3D preoperative planning for distal radius fracture. Three-dimensional digital planning was useful to visualize the reduction process and choose a proper implant for distal radius fractures. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:2646-2651, 2017.

Utility of an image fusion system for 3D preoperative planning and fluoroscopy in the osteosynthesis of distal radius fractures

“…In both groups, 3D digital preoperative planning and a surgical simulation were performed prior to the surgery. The details of the simulation steps were described previously [7]. Reduction and placement of the implants were simulated using software developed by the authors (Zed-Trauma wrist version, LEXI Co., Ltd. Tokyo, Japan).…”

“…3D preoperative planning is good for preprocessing visualization, permitting viewing and understanding of the fracture displacement, and for manipulation images. In a previous study, we developed a 3D preoperative software for fracture management [7]. It was found that the software was useful for visualizing and planning treatment of fractures and choice of implants.…”

Association of Computer-Assisted Virtual Preoperative Planning With Postoperative Mortality and Complications in Older Patients With Intertrochanteric Hip Fracture

“… 11 , 12 , 13 The benefits observed in preoperative planning using virtual surgical technology may be owing to the fact that this approach allows surgeons to observe fracture characteristics, such as the direction of the fracture line, the size of the fracture, and the number and location of fragments. In addition, surgeons can perform the operation virtually 11 , 14 …”

Quantitative Evaluation of Articular Involvement of Posterior Malleolus Associated with Operative Indication: A Comparative Study of Six Methods Based on Radiography and CT

“…So up to now, 3D CT has not been extensively applied in posterior malleolar fracture evaluation nor has it been reported in a study on large sample [22,23]. With the upgrading of computer technology, an efficient system for computer-assisted preoperative planning has been developed [24][25][26]. e use of computer technology enables multilevel and multiangle evaluation of fracture planes.…”