Computer-assisted preoperative planning in the surgical treatment of acetabular fractures

Displaced acetabular fractures are among the most complex of all orthopaedic injuries. Keys to accurate reduction and improved outcomes are accurate imaging studies and a complete understanding of the nature of the fracture. The orientation of complex fractures may be difficult to understand or conceptualize. Traditionally, surgeons have relied on orthogonal Judet views of the pelvis with computed tomography images as tools to use in order to formulate a preoperative plan; however, these modalities may not communicate subtle characteristics of the fracture. The expansion of the power and capabilities of three-dimensional (3D) computer reconstructions has been recognized most recently as a useful adjunct in preoperative planning. The case of a 61-year-old patient with a both-column acetabular fracture and vertically unstable pelvis--in which 3D computer reconstructions and a novel computer-assisted planning tool, Trauma CAD, were used in order to devise an accurate preoperative plan after fully understanding the nature of the injury--is presented.