Pre-operative dynamic interactive exploration of complex articular fractures using a novel 3D navigation tool

Area of Science:

• Medical Imaging
• Surgical Technology
• Orthopedics

Background:

• Trauma surgeons' expertise in pathoanatomy and procedures is underutilized in CT image analysis.
• Current clinical workflows do not integrate surgeons into image generation or processing.
• This gap limits the effective use of advanced imaging for pre-operative diagnosis.

Purpose of the Study:

• To propose and implement a strategy for direct surgeon involvement in dynamic CT image exploration.
• To assess the clinical utility of this approach for diagnosing complex articular fractures pre-operatively.
• To leverage surgeons' domain knowledge for enhanced information extraction from CT data.

Main Methods:

• An interactive 3D navigation tool with a novel human-computer interface was utilized.
• The system enabled dynamic interaction with virtual 3D fracture models.
• Hand movements tracked for on-the-fly oblique multiplanar reformations were employed.

Main Results:

• Three expert surgeons found the interactive system and dynamic exploration helpful for understanding fracture morphology.
• The approach was well-received, indicating potential for improved pre-operative diagnosis.
• Case examples of radius and calcaneal fractures demonstrated the system's application.

Conclusions:

• Involving surgeons in image processing is crucial for leveraging their specialized knowledge.
• Oblique multiplanar reformations offer substantial benefits for pre-operative planning of articular fractures.
• Further evaluation is needed to integrate interactive exploration systems into routine radiological and surgical practice.