Complex fracture reduction by exact identification of the fracture zone.

Abstract

Planning of a fracture reduction is important in order to reduce the surgery time, with the consequent improvement of the recovery process. There are no fully automatic methods that solve an adequate fracture reduction without the intervention of a specialist. Usually there are parameters that must be supervised or adjusted by the specialist, in order to obtain a satisfactory reduction. Furthermore, most of the studies in the literature focus on a certain type of bone and area on it. This paper presents an approach that tries to reduce to some extent the intervention of the specialist, so that it can be closer to an automatic approach. The proposed method can be applied to a wide variety of bones and areas, based on the identification of the complete fracture zone and the use of an ICP algorithm modified to work with the distance between fragments. The cases in which it has been tested are clinical cases of real fractures obtained from CT scan. This method allows working with a wide range of fractures, as well as complex fractures or deformed fragments. Unfortunately, all possible cases and situations could not be obtained and proved, but the method can be successfully applied to cases that meet a set of characteristics. The proposed technique has been validated by experts, both visually and empirically, using a framework based on virtual reality (VR). This VR framework has allowed comparing the reduction performed by the method with a reduction made virtually by specialists. This technique has also been compared with other existing techniques, obtaining a significant improvement over these.