Virtual planning on contralateral hemipelvis for posteriorly fixed acetabular fractures

Agarwal, Gaurang; Mishra, Abhishek; Verma, Tarun; Kumar, Raj; Meena, Abhay; Maini, Lalit

doi:10.1007/s00068-021-01617-z

Cited by 8 publications

(20 citation statements)

References 12 publications

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“…It is also possible to directly use the mirrored contralateral healthy bone or an SSM template for the design of patient-specific implants, leaving out the virtual fracture reduction step. This has been done by inter alia Agarwal et al (2021).…”

Section: Virtual Bone Fracture Reduction Planningmentioning

confidence: 99%

“…Metal 3D printing of implants is also possible and was done by Wang et al (2020a). However, pre-contouring of existing titanium osteosynthesis plates is much more common and has been frequently applied clinically (Li et al, 2015(Li et al, , 2019Zeng et al, 2016;Castro-Núñez et al, 2018;Maini et al, 2018;Chen et al, 2019;Hung et al, 2019;Marschall et al, 2019;Huang et al, 2020;Onodera et al, 2020;Agarwal et al, 2021).…”

Section: D Printed Patient-specific Implants and Pre-contouring Of Pl...mentioning

confidence: 99%

“…Used in references Used for fracture types Materialise Mimics, Leuven, Belgium (Duran-Rodriguez et al;Hu et al, 2011;Liu et al, 2013Liu et al, , 2017Yang et al, 2013;el-Gengehi and Seif, 2015;Huang et al, 2015Huang et al, , 2020Li et al, 2015Li et al, , 2019Zhang et al, 2015Zhang et al, , 2021Wang et al, 2016aWang et al, , 2020bWang et al, , 2020aZeng et al, 2016;Merema et al, 2017;Castro-Núñez et al, 2018;Dreizin et al, 2018;Maini et al, 2018;Sinha et al, 2018;Chen et al, 2019;Hung et al, 2019;Marschall et al, 2019;Mishra et al, 2019;Liang et al, 2020;Ramanathan et al, 2020;Agarwal et al, 2021;IJpma et al, 2021;Nasr et al, 2021;He et al, 2022;Zheng et al, 2022) Total (n = 32): Pelvic/Acetabular fractures (n = 14), Craniomaxillofacial fractures (n = 12), Tibia fractures (n = 3), Humerus fractures (n = 1), Calcaneal fractures (n = 1), Other (n = 1) + 3-matic, Materialise, Leuven, Belgium (Duran-Rodriguez et al;Chen et al, 2019;Marschall et al, 2019;Mishra et al, 2019;Agarwal et al, 2021;IJpma et al, 2021;Zhang et al, 2021) + Geomagic, 3D systems, Rock Hill, SC, USA …”

Section: Systemmentioning

confidence: 99%

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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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Section: Virtual Bone Fracture Reduction Planningmentioning

confidence: 99%

Section: D Printed Patient-specific Implants and Pre-contouring Of Pl...mentioning

confidence: 99%

Section: Systemmentioning

confidence: 99%

See 1 more Smart Citation

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

Moolenaar¹,

Tümer²,

Checa³

2022

Preprint

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Section: Introductionmentioning

confidence: 99%

“…Modern image processing and computer technology make it technically and financially easier for orthopedic surgeons to use virtual planning software in clinical practice [ 7 , 16 , 17 ]. In recent years, the application of computer-assisted virtual planning in complicated surgery of acetabular fractures has been reported with good clinical outcomes [ 13 , 14 , 16 , 18 ]. However, the time consumed for creating virtual three-dimensional (3D) models and the software expertise needed to use this technology are the biggest obstacles to its widespread adoption [ 16 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

One-stop computerized virtual planning system for the surgical management of posterior wall acetabular fractures

et al. 2022

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Background Posterior wall acetabular fractures remain one of the most difficult fracture injuries to treat. Accurate assessment of fracture characteristics and appropriate preoperative surgical strategies are essential for excellent reduction. This paper evaluates the feasibility and effectiveness of a one-stop computerized virtual planning system for the surgical management of posterior wall acetabular fractures. Methods 52 cases of posterior wall acetabular fractures treated surgically were selected in our department between January 2015 and December 2020 for retrospective analysis. 52 cases were classified into group A (25 patients) and group B (27 patients) according to whether computerized virtual planning procedures were performed preoperatively. In group A, virtual surgical simulation was conducted using a one-stop computerized planning system preoperatively. In group B, traditional surgery was employed. Reduction quality, surgical time, blood loss, hip function, complications, and instrumentation time were compared between the two groups. Results The actual surgery for all patients in group A was essentially the same as the virtual surgery before the operation. Compared to group B, patients in group A had markedly shorter surgical time (−43 min), shorter instrumentation time (−20 min), and less intraoperative blood loss (−130 ml). However, no significant statistical difference was observed in reduction quality and hip function. The complication rate was slightly lower in group A (4/25) than in group B (7/27), without a significant difference. Conclusion The one-stop computerized virtual planning system is a highly effective, user-friendly and educational tool for allowing the cost-efficient surgical simulation of posterior wall acetabular fractures and providing a more individualized therapeutic schedule. The one-stop computerized planning system is feasible to treat posterior wall acetabular fractures, which is an effective method than the conventional treatment of posterior wall acetabular fractures. Trial registration: retrospective registration.

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Automatic virtual reconstruction of acetabular fractures using a statistical shape model

van Veldhuizen,

van Noortwijk,

Meesters

et al. 2024

Eur J Trauma Emerg Surg

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Purpose Automatic virtual reconstruction of complex fractures would be helpful for pre-operative surgical planning. We developed a statistical shape model (SSM) which contains data of 200 intact 3D hemipelves. It allows for quantification of shape differences and is able to reconstruct abnormal shaped pelvises. We applied our SSM to reconstruct elementary and associate type acetabular fractures and assessed the reconstruction performance of the SSM, by comparing the reconstructed shape with the intact contralateral hemipelvis. Methods In this retrospective diagnostic imaging study, we used our SSM to virtually reconstruct fractured hemipelves of eighty-three patients with an acetabular fracture. A root mean square error (RMSE) was computed between the reconstructed shape and intact contralateral shape for the whole hemipelvis and for regions relevant for plate-fitting. These plate-fitting relevant regions were defined as: (1) Iliopectineal line length and radius; (2) ischial body line length and radius; (3) acetabular diameter, (4) quadrilateral slope and (5) weight-bearing acetabular dome. Results The median RMSE of the whole hemipelvis of the elementary type fractures was 2.2 (1.7–2.5) mm versus 3.2 (2.2–3.9) mm for the associate type fractures (p < 0.001). The median RMSE for the plate-fitting regions of elementary type fractures was 1.7 (1.4–2.1) mm versus 2.7 (2.0–4.1) mm for associate type fractures (p < 0.001). Conclusion Using a statistical shape model allows for accurate virtual reconstructions of elementary and associate type acetabular fractures within a clinically acceptable range, especially within regions important for plate-fitting. SSM-based reconstructions can serve as a valuable tool for pre-operative planning in clinical practice, when a template of the contralateral hemipelvis is unavailable.

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Virtual planning on contralateral hemipelvis for posteriorly fixed acetabular fractures

Cited by 8 publications

References 12 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

One-stop computerized virtual planning system for the surgical management of posterior wall acetabular fractures

Automatic virtual reconstruction of acetabular fractures using a statistical shape model

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