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International Journal of Computer Assisted Radiology and Surgery

Erschienen in:

01.10.2015 | Original Article

Haptic computer-assisted patient-specific preoperative planning for orthopedic fractures surgery

verfasst von: I. Kovler, L. Joskowicz, Y. A. Weil, A. Khoury, A. Kronman, R. Mosheiff, M. Liebergall, J. Salavarrieta

Erschienen in: International Journal of Computer Assisted Radiology and Surgery | Ausgabe 10/2015

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Abstract

Purpose

The aim of orthopedic trauma surgery is to restore the anatomy and function of displaced bone fragments to support osteosynthesis. For complex cases, including pelvic bone and multi-fragment femoral neck and distal radius fractures, preoperative planning with a CT scan is indicated. The planning consists of (1) fracture reduction—determining the locations and anatomical sites of origin of the fractured bone fragments and (2) fracture fixation—selecting and placing fixation screws and plates. The current bone fragment manipulation, hardware selection, and positioning processes based on 2D slices and a computer mouse are time-consuming and require a technician.

Methods

We present a novel 3D haptic-based system for patient-specific preoperative planning of orthopedic fracture surgery based on CT scans. The system provides the surgeon with an interactive, intuitive, and comprehensive, planning tool that supports fracture reduction and fixation. Its unique features include: (1) two-hand haptic manipulation of 3D bone fragments and fixation hardware models; (2) 3D stereoscopic visualization and multiple viewing modes; (3) ligaments and pivot motion constraints to facilitate fracture reduction; (4) semiautomatic and automatic fracture reduction modes; and (5) interactive custom fixation plate creation to fit the bone morphology.

Results

We evaluate our system with two experimental studies: (1) accuracy and repeatability of manual fracture reduction and (2) accuracy of our automatic virtual bone fracture reduction method. The surgeons achieved a mean accuracy of less than 1 mm for the manual reduction and 1.8 mm (std \(=\) 1.1 mm) for the automatic reduction.

Conclusion

3D haptic-based patient-specific preoperative planning of orthopedic fracture surgery from CT scans is useful and accurate and may have significant advantages for evaluating and planning complex fractures surgery.

Vorheriger Artikel Comparison of 3D C-arm fluoroscopy and 3D image-guided navigation for minimally invasive pelvic surgery

Nächster Artikel MyHip: supporting planning and surgical guidance for a better total hip arthroplasty

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Titel: Haptic computer-assisted patient-specific preoperative planning for orthopedic fractures surgery
verfasst von: I. Kovler
L. Joskowicz
Y. A. Weil
A. Khoury
A. Kronman
R. Mosheiff
M. Liebergall
J. Salavarrieta
Publikationsdatum: 01.10.2015
Verlag: Springer Berlin Heidelberg
Erschienen in: International Journal of Computer Assisted Radiology and Surgery / Ausgabe 10/2015
Print ISSN: 1861-6410
Elektronische ISSN: 1861-6429
DOI: https://doi.org/10.1007/s11548-015-1162-9

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Abstract

Purpose

Methods

Results

Conclusion

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