Int J Comput Assist Radiol Surg - Computer-assisted fracture reduction: a new approach for repositioning femoral fractures and planning reduction paths.

Tópicos

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Resumo

RPOSE: Reduction is a crucial step in the surgical treatment of bone fractures to achieve anatomical alignment and facilitate healing. Surgical planning for treatment of simple femoral fractures requires suitable gentle reduction paths. A plan with optimal movement of fracture fragments from the initial to the desired target position should improve the reduction procedure. A virtual environment which repositions the fracture fragments automatically and provides the ability to plan reduction paths was developed and tested.METHODS: Virtual 3D osseous fragments are created from CT scans. Based on the computed surface curvatures, strongly curved edges are selected and fracture lines are generated. After assignment of matching points, the lines are compared and the desired target position is calculated. Planning of reduction paths was achieved using a reference-coordinate-system for the computation of reduction parameters. The fracture is reduced by changing the reduction parameters step by step until the target position is reached. To test this system, nine different fractured SYNBONE models and one human fracture were reduced, based on CT scans with varying resolution.RESULTS: The highest mean translational error is 1.2 ? 0.9 (mm), and the rotational error is 2.6? ? 2.8 (?), both of which are considered as clinically acceptable. The reduction paths can be planned manually or semi-automatically for each fracture.CONCLUSIONS: Automated fracture reduction was achieved using a system based on preoperative CT scans. The automated system provides a clinically feasible basis for planning optimal reduction paths that may be augmented by further computer- or robot-assisted applications.

Resumo Limpo

rpose reduct crucial step surgic treatment bone fractur achiev anatom align facilit heal surgic plan treatment simpl femor fractur requir suitabl gentl reduct path plan optim movement fractur fragment initi desir target posit improv reduct procedur virtual environ reposit fractur fragment automat provid abil plan reduct path develop testedmethod virtual d osseous fragment creat ct scan base comput surfac curvatur strong curv edg select fractur line generat assign match point line compar desir target posit calcul plan reduct path achiev use referencecoordinatesystem comput reduct paramet fractur reduc chang reduct paramet step step target posit reach test system nine differ fractur synbon model one human fractur reduc base ct scan vari resolutionresult highest mean translat error mm rotat error consid clinic accept reduct path can plan manual semiautomat fractureconclus autom fractur reduct achiev use system base preoper ct scan autom system provid clinic feasibl basi plan optim reduct path may augment comput robotassist applic

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