Abstract
BackgroundRecently, computerized virtual surgery planning has been increasingly applied in various orthopedic procedures. In this study, we developed an image fusion system for 3D preoperative planning and fluoroscopy for the osteosynthesis. To assess the utility of image fusion system, we evaluated the reproducibility of preoperative planning in the osteosynthesis of distal radius fractures with using the image fusion system, and compared with the reproducibility of the patients without using the image fusion system.MethodsForty-two wrists of 42 distal radius fracture patients who underwent osteosynthesis using volar locking plates were evaluated. The patients were divided into two groups. Image fusion group utilized three-dimensional (3D) preoperative planning and image fusion system. Control group utilized only 3D preoperative planning. In both groups, 3D preoperative planning was performed in order to determine reduction, placement, and choice of implants. In the image fusion group, the outline of planned image was displayed on a monitor overlapping with fluoroscopy images during surgery. Reductions were evaluated by volar tilt and radial inclination of 3D images. Plate positions were evaluated with distance to joint surface, plate center axis position, and inclination relative to the radius axis. Screw choices were recorded for the plan and actual choices for each screw hole. Differences in the parameters between pre- and postoperative images were evaluated. Differences in reduction shape, plate positions, and screw choices were compared between groups.ResultsThe differences in the distance from plate to joint surface were significantly smaller in the image fusion group compared to the control group (P < 0.01). The differences in the distal screw choices were significantly smaller in the image fusion group compared to the control group (P < 0.01).ConclusionsThe image fusion system was useful to reproduce the planned plate position and distal screw choices in the osteosynthesis of distal radius fractures.Trial registrationClinicalTrials.gov, NCT03764501
Highlights
Computerized virtual surgery planning has been increasingly applied in various orthopedic procedures
While it is unclear whether or not the use of these methods improves clinical outcomes, there may be some benefits for fracture reduction and less extensive dissection because of a better understanding of fracture shape [6]. 3D preoperative planning is good for preprocessing visualization, permitting viewing and understanding of the fracture displacement, and for manipulation images
We assessed the utility of an image fusion system by evaluating the reproducibility of preoperative planning in the osteosynthesis of distal radius fractures
Summary
Computerized virtual surgery planning has been increasingly applied in various orthopedic procedures. To assess the utility of image fusion system, we evaluated the reproducibility of preoperative planning in the osteosynthesis of distal radius fractures with using the image fusion system, and compared with the reproducibility of the patients without using the image fusion system. Three-dimensional (3D) preoperative planning and Yoshii et al Journal of Orthopaedic Surgery and Research (2019) 14:342 intraoperative navigation systems are clinically utilized for fracture management [1,2,3,4,5] While it is unclear whether or not the use of these methods improves clinical outcomes, there may be some benefits for fracture reduction and less extensive dissection because of a better understanding of fracture shape [6]. We assessed the utility of an image fusion system by evaluating the reproducibility of preoperative planning in the osteosynthesis of distal radius fractures. The reproducibility was compared with the postoperative results of patients treated without using an image fusion system
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