An interactive surgical planning tool for acetabular fractures: initial results

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Virtual Reality

Background:

• Acetabular fractures are complex to treat due to intricate anatomy and surgical access challenges.
• Accurate preoperative planning is crucial for achieving anatomic reduction and stable fixation.
• Existing methods may not fully address the complexities of these fractures.

Purpose of the Study:

• To test the feasibility of a novel virtual reality (VR) planning tool for acetabular fractures.
• To evaluate the tool's ability to aid in preoperative surgical planning and implant contouring.
• To assess the integration of VR technology into the clinical workflow for pelvic surgery.

Main Methods:

• Prospective inclusion of 7 patients with acetabular fractures (excluding simple wall fractures).
• Development of patient-specific bone models from CT scans for VR environment.
• Interactive virtual fracture reduction with visuo-haptic feedback and virtual fixation.
• Preoperative contouring of osteosynthesis plates based on virtual planning.

Main Results:

• Preoperative planning was feasible in all 7 cases.
• Good to excellent correlation between preoperative planning and postoperative results in 6 out of 7 cases.
• Patient-specific prebent plates aided reduction in osteopenic bone cases; intraoperative navigation was enhanced.

Conclusions:

• The VR prototype planning tool was successfully integrated into a clinical workflow.
• The tool provides valuable visual and haptic information for patient-specific preoperative planning.
• It allows for tailored adaptation of osteosynthesis implants to the virtually reduced pelvis.