Application of virtual overlapping technology for the selection of appropriate metal plate dimensions in rib fracture
Shaohui Song1, Jianqiu Yang2, Chi Zhang3
1Department of Cardiothoracic Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.
Background:
Rib fractures are a frequent consequence of thoracic trauma. Although surgical stabilization of rib fracture (SSRF) is the established treatment for severe cases, selecting appropriate rib-encircling plates remains a predominantly subjective, intraoperative process. This empirical assessment carries an inherent risk of implant-anatomy mismatch. This study aimed to evaluate the feasibility and accuracy of a three-dimensional (3D) "virtual overlapping" technique for determining optimal plate dimensions prior to surgery.
Methods:
This prospective cohort study enrolled 29 consecutive adult patients with multiple displaced rib fractures (displacement ≥1 shaft width). 3D rib models were generated from preoperative computed tomography (CT) scans. Digital templates of titanium and memory-alloy plates were virtually matched to the fracture sites to preoperatively select the optimal implant size. The primary outcome was intraoperative concordance between the pre-selected size and the actual implanted plate.
Results:
The cohort included 29 patients (21 males, 8 females; mean age, 56.2±14.6 years). Comprehensive preoperative planning, specifically targeting 2-3 critical fracture ends, required approximately 1.5-2 hours per case. Preoperative virtual sizing was successfully performed for all patients. Intraoperative verification confirmed that the pre-selected plates achieved secure fixation and appropriate anatomical fit in all 29 cases (100% concordance), with no need for intraoperative hardware exchange. Postoperative CT confirmed precise plate apposition to the rib surface, with no need for intraoperative hardware exchange.
Conclusions:
Integrating 3D virtual overlapping technology into preoperative planning is feasible and enables accurate plate sizing. This approach offers an objective method to reduce intraoperative uncertainty and potential sizing errors in rib fracture surgery.
