Virtual planning on contralateral hemipelvis for posteriorly fixed acetabular fractures

Area of Science:

• Orthopedic Surgery
• Medical Imaging
• Surgical Planning

Background:

• Open reduction and internal fixation with 3.5 mm reconstruction plates is standard for acetabular fractures.
• Intra-operative contouring is time-consuming and increases surgical morbidity.
• Virtual surgical planning (VSP) aids in managing complex orthopedic cases.

Purpose of the Study:

• To evaluate the efficacy of using the contralateral intact hemipelvis for VSP of patient-specific pre-contoured plates for acetabular fractures.
• To compare the time efficiency of VSP on fractured versus intact hemipelvis.

Main Methods:

• Thirty patients with acetabular fractures underwent posterior fixation (Kocher-Langenbeck approach).
• VSP was performed on the contralateral intact hemipelvis to create patient-specific plates, mirrored to the fractured side.
• Planning time was recorded and compared; surgical outcomes (duration, blood loss, reduction) were assessed.

Main Results:

• VSP time was significantly less using the contralateral intact hemipelvis (mean 15.67 min) compared to the fractured side (mean 81.83 min).
• Outcomes including blood loss, surgical duration, and radiographic reduction were comparable or superior to existing literature.
• Patient-specific pre-contoured plates facilitated efficient surgical fixation.

Conclusions:

• Virtual preoperative planning using the contralateral normal pelvis is a more efficient and less time-consuming approach.
• This technique simplifies the pre-operative planning process for acetabular fracture fixation.
• Utilizing the intact contralateral side offers a practical advantage in VSP for acetabular fractures.