Preoperative planning program tool in treatment of articular fractures: Process of segmentation procedure

Abstract

a developing computer program for preoperative planning of articular fractures is presented. The program consists of three closely integrated tools, the 3D viewing tools, the segmentation tools and the reduction and fixation simulating tools. Data from CT of a fracture in DICOM format are used. First the 3D model is made, and then segmentation is carried out, where each fracture segment is made as an individual object. In reduction each fracture segment can be moved in all three directions, can be rotated in all planes and its pivot point of rotation can be changed. After reduction fixation can be undertaken, either with plates that can be automatically contoured or with pre curved plates that are already in program database. The plan of automatically contoured plates can be drawn and printed out in 1:1 scale. The most important is that all the steps can be carried out on a personal computer by the surgeon who is doing the preoperative planning. This is the complete novelty since segmentation can be carried out by the surgeon. In that way all the fracture lines are studied in preoperative planning. The procedure is quick and easy. This is why we made segmentation in 20 consecutive cases that were admitted to our department of fresh articular fractures where CT was indicated and done that were admitted to our department. The steps needed in segmentation process were recorded and fractures were described whether there were luxation, multifragmentary or impaction fractures and classified according to AO classification. The presented computer program is an easily usable application which brings significant value and new opportunities in clinical practice, teaching and research. © 2010 International Federation for Medical and Biological Engineering.