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Computed tomography-based virtual fracture reduction techniques in bimandibular fractures
Jan Oliver Voss1, Viktor Varjas2, Jan-Dirk Raguse3
1AO Research Institute Davos, Clavadelerstrasse 8, 7270 Davos, Switzerland; Department of Oral & Maxillofacial Surgery, Charité Universitätsmedizin Berlin, Campus Virchow- Klinikum, Augustenburger Platz 1, Berlin, 13353, Germany.
Summary
This study introduces a CT-based virtual fracture reduction technique for bimandibular fractures. This computer-assisted preoperative planning method enhances surgical options for complex mandibular fractures.
Area of Science:
- Craniomaxillofacial Surgery
- Medical Imaging
- Computer-Aided Surgery
Background:
- Computer-assisted preoperative planning (CAPP) is established in craniomaxillofacial surgery, often using CT or CBCT.
- Virtual fracture reduction is a key component of advanced CAPP.
Purpose of the Study:
- To implement and evaluate a CT-based virtual fracture reduction technique for patients with bimandibular fractures.
- To assess the utility of this technique for surgical planning.
Main Methods:
- Nine preoperative CT scans of patients with bilateral mandibular fractures were processed.
- A mean mandible model and specialized Amira software with custom scripts were utilized.
- The technique involved 3D modeling, mandible segmentation, fracture fragment identification, and virtual reduction.
Main Results:
- A computerized method was developed for 3D modeling, mandible separation, and virtual reduction of fracture fragments.
- User input was necessary for landmark labeling of fragments.
- Virtual reduction was achieved using landmarks or the unaffected contralateral side as references.
Conclusions:
- An effective CT-based virtual fracture reduction technique for the mandible was successfully developed.
- This method expands planning capabilities for osteosynthesis and custom surgical guides.
- CAPP for complex mandibular fractures is justified and can complement routine CT assessment.
