Utility of an image fusion system for 3D preoperative planning and fluoroscopy in the osteosynthesis of distal radius fr
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(2019) 14:342
RESEARCH ARTICLE
Open Access
Utility of an image fusion system for 3D preoperative planning and fluoroscopy in the osteosynthesis of distal radius fractures Yuichi Yoshii1* , Yasukazu Totoki2, Satoshi Sashida3, Shinsuke Sakai1 and Tomoo Ishii1
Abstract Background: Recently, computerized virtual surgery planning has been increasingly applied in various orthopedic procedures. In this study, we developed an image fusion system for 3D preoperative planning and fluoroscopy for the osteosynthesis. To assess the utility of image fusion system, we evaluated the reproducibility of preoperative planning in the osteosynthesis of distal radius fractures with using the image fusion system, and compared with the reproducibility of the patients without using the image fusion system. Methods: Forty-two wrists of 42 distal radius fracture patients who underwent osteosynthesis using volar locking plates were evaluated. The patients were divided into two groups. Image fusion group utilized three-dimensional (3D) preoperative planning and image fusion system. Control group utilized only 3D preoperative planning. In both groups, 3D preoperative planning was performed in order to determine reduction, placement, and choice of implants. In the image fusion group, the outline of planned image was displayed on a monitor overlapping with fluoroscopy images during surgery. Reductions were evaluated by volar tilt and radial inclination of 3D images. Plate positions were evaluated with distance to joint surface, plate center axis position, and inclination relative to the radius axis. Screw choices were recorded for the plan and actual choices for each screw hole. Differences in the parameters between pre- and postoperative images were evaluated. Differences in reduction shape, plate positions, and screw choices were compared between groups. Results: The differences in the distance from plate to joint surface were significantly smaller in the image fusion group compared to the control group (P < 0.01). The differences in the distal screw choices were significantly smaller in the image fusion group compared to the control group (P < 0.01). Conclusions: The image fusion system was useful to reproduce the planned plate position and distal screw choices in the osteosynthesis of distal radius fractures. Trial registration: ClinicalTrials.gov, NCT03764501 Keywords: Image fusion, Preoperative plan, Fluoroscopy, Distal radius fracture, Computed tomography, Osteosynthesis
Background The main points for the treatment of fractures are to acquire anatomical reduction and to reconstruct a biomechanically stable joint in relation to the diaphysis with correct alignment of the axis and rotation. To achieve anatomical reduction and appropriate implant choices in the osteosynthesis of fractures, preoperative * Correspondence: [email protected] 1 Department of Orthopaedic Surgery, Tokyo Medical University Ibaraki Medical Center, 3-20-1 Chuo, Ami, Inashiki, Ibaraki 300-0395, Japan Full list of author information is available at the end of
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