Computer-aided position planning of miniplates to treat facial bone defects.

Jan Egger,Xiaojun Chen,Markus Gall,Jürgen Wallner,Knut Reinbacher,Katja Schwenzer-Zimmerer,Dieter Schmalstieg

doi:10.1371/journal.pone.0182839

Abstract

In this contribution, a software system for computer-aided position planning of miniplates to treat facial bone defects is proposed. The intra-operatively used bone plates have to be passively adapted on the underlying bone contours for adequate bone fragment stabilization. However, this procedure can lead to frequent intra-operatively performed material readjustments especially in complex surgical cases. Our approach is able to fit a selection of common implant models on the surgeon’s desired position in a 3D computer model. This happens with respect to the surrounding anatomical structures, always including the possibility of adjusting both the direction and the position of the used osteosynthesis material. By using the proposed software, surgeons are able to pre-plan the out coming implant in its form and morphology with the aid of a computer-visualized model within a few minutes. Further, the resulting model can be stored in STL file format, the commonly used format for 3D printing. Using this technology, surgeons are able to print the virtual generated implant, or create an individually designed bending tool. This method leads to adapted osteosynthesis materials according to the surrounding anatomy and requires further a minimum amount of money and time.

Highlights

The Reconstructions of facial deformations and defects due to bone fractures where two bone fragments are operatively stabilized, so called osteosynthesis, is part of a surgeon’s daily life
All experts are familiar with the state of the art techniques in facial reconstructions and the performed evaluation consisted of three main steps
The physicians performed the planning of an implant on their own, where we described the case to be solved with the following words: Load the given data set and perform the placement of a mandibular media fracture using at least two implants of different model type and export the data to the desktop, if satisfaction is reached

Summary

Introduction

The Reconstructions of facial deformations and defects due to bone fractures where two bone fragments are operatively stabilized, so called osteosynthesis, is part of a surgeon’s daily life These bone fractures occur as a result of applied outer forces, like happening due to traffic accidents, results of tumor removal or deformation treatment [1]. One major cause for facial fractures in regions where winter sports are frequently practiced is skiing and snowboarding [2]

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