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

Yoshii, Yukie; Totoki, Yasukazu; Sashida, Satoshi; Sakai, Shinsuke; Ishii, Tomoo

doi:10.1186/s13018-019-1370-z

Cited by 17 publications

(24 citation statements)

References 26 publications

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“…The feasibility of CT-based virtual preoperative planning has been investigated in previous studies [ 18 – 21 ]. Compared with the traditional preoperative planning techniques using handwriting hardcopy radiographs along with tracing paper or simple measurements in the PACS, the CT-based 3D preoperative planning was proven to provide better understanding of fracture shape and displacement, especially in intra-articular fractures [ 22 , 23 ]. In our case series, the collapsed intra-articular fragment as well as the characteristics of the comminuted dorsal cortex were carefully analyzed preoperatively in the 3D digital model.…”

Section: Discussionmentioning

confidence: 99%

A modified intrafocal pinning technique with three‐dimensional planning to facilitate volar plating in dorsally comminuted AO/OTA C2 and C3 distal radius fractures

Gui

Xiong

et al. 2021

BMC Musculoskelet Disord

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Backgrounds Theaim of this study was to assess the efficacy of a modified intrafocal pinningtechnique with three-dimensional (3D) planning to facilitate volar plating in dorsally comminuted intra-articular distal radius fractures. Methods Intotal 35 AO/OTA type C2 and C3 fractures were finally included.The 3D digital model of the fracture was reconstructed based on preoperative computedtomographic (CT) images, with the displacement of the comminuted dorsalfragment and the intra-articular fragment analyzed for preoperative planning. During operation, amodified intrafocal pinning technique was applied percutaneously from thedorsal aspect of the radius to reduce the collapsed intra-articular fragmentfollowing volar plating. Adequate reduction was confirmed in all of patientsconsidering radial height, radial inclination and volar tilt in postoperativeradiographs. Results No significant fracture re-displacement wasobserved in most of the cases during a mean follow-up period of 17.4 months, exceptfor two patients withthe C3 fracture. All of the patients achieved adequate clinicalROMs at 12 months postoperatively, with a mean DASH score of 12.0. Most of the patients achievedan excellent (n = 21) or good (n = 12) Gartland and Werley wrist score. Conclusions Ourmodified intrafocal pinning technique with 3D planning contributes to a satisfactoryclinical and radiological outcome in dorsally comminuted intra-articular distalradius fractures fixed with a volar locking plate. Trialregistration Notapplicable because the design of the study is retrospective.

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Section: Discussionmentioning

confidence: 99%

A modified intrafocal pinning technique with three‐dimensional planning to facilitate volar plating in dorsally comminuted AO/OTA C2 and C3 distal radius fractures

Gui

Xiong

et al. 2021

BMC Musculoskelet Disord

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“…За последние годы в иностранной литературе появились работы, посвященные трехмерному предоперационному планированию и интраоперационным навигационным системам при лечении переломов [3].…”

Section: Discussionunclassified

A preoperative planning method for long tubular bone osteosynthesis

Pankratov

Pankratov²,

Lartsev

et al. 2020

Science and Innovations in Medicine

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Objectives the development of a preoperative planning method for long tubular bone osteosynthesis using the contralateral healthy bone. Material and methods.To justify the usage of the opposite limbs intact segment model in order to reconstruct the damaged one, their matching in shape and size was analyzed. We built three-dimensional models of the right and left segments of the upper limbs of 20 people and compared them using the Hausdorff distance calculation algorithm. For treatment of a 24-year-old patient with a closed humerus fracture, an individual stereolithographic surgical template with fracture lines was created with the help of computed tomography data of the healthy humerus bone processed by AUTOPLAN EXPERT software. This template was used for pre-bending the plate for osteosynthesis. The plate positioning on the template defined the surgical approach, taking into account the anatomical structures located in the projection of the fracture line and the plate. The technique of "reverse bone reposition" on the prepared plate was applied. Results.With the help of the created 3D models we revealed the size differences of the symmetrical segments of upper limbs. The greatest difference in the limits was registered in the area of the epiphyses (heads of the humeri) up to 6.8 mm, and the smallest throughout the entire diaphysis, less than 1.5 mm. Due to preoperative planning there were no intraoperative and postoperative complications, the installation of the plate and osteosynthesis was convenient. The fracture consolidation took place in 3 months. Conclusion.The proposed method has a number of advantages. It is possible to make a stereolithographic template even for a seriously damaged bone with a copied fracture line. This allows the surgeon to plan the details of osteosynthesis, to model the plate according to the template, to determine the required length and shape of the surgical approach, thus reducing the surgical risks and injury for the patient.

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“…The feasibility of CT-based virtual preoperative planning has been investigated in previous studies [18][19][20][21]. Compared with the traditional preoperative planning techniques using handwriting hardcopy radiographs along with tracing paper or simple measurements in the PACS, the CT-based 3D preoperative planning was proven to provide better understanding of fracture shape and displacement, especially in intra-articular fractures [22,23]. In our case series, the collapsed intra-articular fragment as well as the characteristics of the comminuted dorsal cortex were carefully analyzed preoperatively in the 3D digital model, which provided guidance for the entry point and orientation of intrafocal pinning.…”

Section: Discussionmentioning

confidence: 99%

A modified intrafocal pinning technique with three-dimensional planning to facilitate volar plating in dorsally comminuted AO/OTA C2 and C3 distal radius fractures

Gui

Shi

Xiong

et al. 2020

Preprint

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Backgrounds: The aim of this study was to assess the efficacy of a modified intrafocal pinning technique with three-dimensional (3D) planning to facilitate volar plating in dorsally comminuted intra-articular distal radius fractures.Methods: In total 35 AO/OTA type C2 and C3 fractures were finally included. The 3D digital model of the fracture was reconstructed based on preoperative computed tomographic (CT) images, with the displacement of the comminuted dorsal fragment and the intra-articular fragment analyzed for preoperative planning. During operation, a modified intrafocal pinning technique was applied percutaneously from the dorsal aspect of the radius to reduce the collapsed intra-articular fragment following volar plating. Adequate reduction was confirmed in all of patients considering radial height, radial inclination and volar tilt in postoperative radiographs.Results: No significant fracture re-displacement was observed in most of the cases during a mean follow-up period of 17.4 months, except for two patients with the C3 fracture. All of the patients achieved adequate clinical ROMs at 12 months postoperatively, with a mean DASH score of 12.0. Most of the patients achieved an excellent (n = 21) or good (n = 12) Gartland and Werley wrist score.Conclusions: Our modified intrafocal pinning technique with 3D planning contributes to a satisfactory clinical and radiological outcome in dorsally comminuted intra-articular distal radius fractures fixed with a volar locking plate.Trial registration: Not applicable because the design of the study is retrospective.

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

Cited by 17 publications

References 26 publications

A modified intrafocal pinning technique with three‐dimensional planning to facilitate volar plating in dorsally comminuted AO/OTA C2 and C3 distal radius fractures

A modified intrafocal pinning technique with three‐dimensional planning to facilitate volar plating in dorsally comminuted AO/OTA C2 and C3 distal radius fractures

A preoperative planning method for long tubular bone osteosynthesis

A modified intrafocal pinning technique with three-dimensional planning to facilitate volar plating in dorsally comminuted AO/OTA C2 and C3 distal radius fractures

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