Comput. Aided Surg. - 3D atlas-based registration can calculate malalignment of femoral shaft fractures in six degrees of freedom.

Tópicos

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Resumo

JECTIVE: This study presents and evaluates a semi-automated algorithm for quantifying malalignment in complex femoral shaft fractures from a single intraoperative cone-beam CT (CBCT) image of the fractured limb.METHODS: CBCT images were acquired of complex comminuted diaphyseal fractures created in 9 cadaveric femora (27 cases). Scans were segmented using intensity-based thresholding, yielding image stacks of the proximal, distal and comminuted bone. Semi-deformable and rigid affine registrations to an intact femur atlas (synthetic or cadaveric-based) were performed to transform the distal fragment to its neutral alignment. Leg length was calculated from the volume of bone within the comminution fragment. The transformations were compared to the physical input malalignments.RESULTS: Using the synthetic atlas, translations were within 1.71 ? 1.08 mm (medial/lateral) and 2.24 ? 2.11 mm (anterior/posterior). The varus/valgus, flexion/extension and periaxial rotation errors were 3.45 ? 2.6?, 1.86 ? 1.5? and 3.4 ? 2.0?, respectively. The cadaveric-based atlas yielded similar results in medial/lateral and anterior/posterior translation (1.73?1.28mm and 2.15 ? 2.13 mm, respectively). Varus/valgus, flexion/extension and periaxial rotation errors were 2.3 ? 1.3?, 2.0 ? 1.6? and 3.4 ? 2.0?, respectively. Leg length errors were 1.41 ? 1.01 mm (synthetic) and 1.26 ? 0.94 mm (cadaveric). The cadaveric model demonstrated a small improvement in flexion/extension and the synthetic atlas performed slightly faster (6 min 24 s ? 50 s versus 8 min 42 s ? 2 min 25 s).CONCLUSIONS: This atlas-based algorithm quantified malalignment in complex femoral shaft fractures within clinical tolerances from a single CBCT image of the fractured limb.

Resumo Limpo

jectiv studi present evalu semiautom algorithm quantifi malalign complex femor shaft fractur singl intraop conebeam ct cbct imag fractur limbmethod cbct imag acquir complex comminut diaphys fractur creat cadaver femora case scan segment use intensitybas threshold yield imag stack proxim distal comminut bone semideform rigid affin registr intact femur atlas synthet cadavericbas perform transform distal fragment neutral align leg length calcul volum bone within comminut fragment transform compar physic input malalignmentsresult use synthet atlas translat within mm mediallater mm anteriorposterior varusvalgus flexionextens periaxi rotat error respect cadavericbas atlas yield similar result mediallater anteriorposterior translat mm mm respect varusvalgus flexionextens periaxi rotat error respect leg length error mm synthet mm cadaver cadaver model demonstr small improv flexionextens synthet atlas perform slight faster min s s versus min s min sconclus atlasbas algorithm quantifi malalign complex femor shaft fractur within clinic toler singl cbct imag fractur limb

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