Surgeon-oriented three-dimensional planning for supracondylar humeral malunion

Area of Science:

• Orthopedic Surgery
• Biomedical Engineering
• Medical Imaging

Background:

• Supracondylar humeral fractures often result in complex 3D rotational malunions.
• Current pre-operative planning relies on engineers, limiting surgeon autonomy.
• A surgeon-oriented method for quantifying these deformities is needed.

Purpose of the Study:

• To establish a practical, surgeon-oriented computational framework for quantifying 3D rotational deformities in humerus malunions.
• To enable independent pre-operative planning for corrective osteotomy.

Main Methods:

• Developed a 3D rotation analysis method using mirrored bone models and defined coordinate systems.
• Calculated rotational deformities using three distinct approaches (Methods A, B, C).
• Validated the method using CT data from five patients and assessed robustness against landmark selection and coordinate precision.

Main Results:

• Methods A and B demonstrated minimal variability (<0.02°) across landmark selections.
• Method C showed consistency relative to rotation magnitude.
• The method proved robust to clinically realistic coordinate precision.

Conclusions:

• A robust, surgeon-oriented method for quantifying 3D rotational deformities in humerus malunion was established.
• The method reduces reliance on engineering support and facilitates independent surgical planning.
• Consistency between 3D and simplified coronal-plane estimates supports its clinical applicability.