ASB Clinical Biomechanics Award Paper 2010 Virtual pre-operative reconstruction planning for comminuted articular fractures

Thaddeus P Thomas; Donald D Anderson; Andrew R Willis; Pengcheng Liu; J Lawrence Marsh; Thomas D Brown

doi:10.1016/j.clinbiomech.2010.12.008

$ASB Clinical Biomechanics Award Paper 2010 Virtual pre-operative reconstruction planning for comminuted articular fractures$

Journal article

Open access

Peer reviewed

ASB Clinical Biomechanics Award Paper 2010 Virtual pre-operative reconstruction planning for comminuted articular fractures

Thaddeus P Thomas, Donald D Anderson, Andrew R Willis, Pengcheng Liu, J Lawrence Marsh and Thomas D Brown

Clinical biomechanics (Bristol), Vol.26(2), pp.109-115

02/2011

DOI: 10.1016/j.clinbiomech.2010.12.008

PMCID: PMC3034816

PMID: 21215501

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Abstract

Highly comminuted intra-articular fractures are complex and difficult injuries to treat. Once emergent care is rendered, the definitive treatment objective is to restore the original anatomy while minimizing surgically induced trauma. Operations that use limited or percutaneous approaches help preserve tissue vitality, but reduced visibility makes reconstruction more difficult. A pre-operative plan of how comminuted fragments would best be re-positioned to restore anatomy helps in executing a successful reduction. In this study, the methods for virtually reconstructing a tibial plafond fracture were developed and applied to clinical cases. Building upon previous benchtop work, novel image analysis techniques and puzzle solving algorithms were developed for clinical application. Specialty image analysis tools were used to segment the fracture fragment geometries from CT data. The original anatomy was then restored by matching fragment native (periosteal and subchondral) bone surfaces to an intact template, generated from the uninjured contralateral limb. Virtual reconstructions obtained for ten tibial plafond fracture cases had average alignment errors of 0.39 (0.5 standard deviation) mm. In addition to precise reduction planning, 3D puzzle solutions can help identify articular deformities and bone loss. The results from this study indicate that 3D puzzle solving provides a powerful new tool for planning the surgical reconstruction of comminuted articular fractures.

User-Computer Interface

Humans

Reconstructive Surgical Procedures - methods

Awards and Prizes

Fracture Fixation, Internal - methods

Surgery, Computer-Assisted - methods

Preoperative Care

Biomedical Engineering

Computer Graphics

Tibial Fractures - surgery

Tibial Fractures - physiopathology

Models, Biological

Computer Simulation

Fractures, Comminuted - physiopathology

Fractures, Comminuted - surgery

Details

Title: Subtitle: ASB Clinical Biomechanics Award Paper 2010 Virtual pre-operative reconstruction planning for comminuted articular fractures
Creators: Thaddeus P Thomas - Department of Orthopaedics & Rehabilitation, The University of Iowa, Iowa City, 52242, USA
Donald D Anderson
Andrew R Willis
Pengcheng Liu
J Lawrence Marsh
Thomas D Brown
Resource Type: Journal article
Publication Details: Clinical biomechanics (Bristol), Vol.26(2), pp.109-115
DOI: 10.1016/j.clinbiomech.2010.12.008
PMID: 21215501
PMCID: PMC3034816
NLM abbreviation: Clin Biomech (Bristol)
ISSN: 0268-0033
eISSN: 1879-1271
Publisher: England
Grant note: R21 AR054015-01A2 / NIAMS NIH HHS P50 AR055533 / NIAMS NIH HHS P50AR055533 / NIAMS NIH HHS R21AR054015 / NIAMS NIH HHS P50 AR055533-01 / NIAMS NIH HHS R21 AR054015 / NIAMS NIH HHS
Language: English
Date published: 02/2011
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Industrial and Systems Engineering
Record Identifier: 9984040004302771

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