Use of a virtual 3D software for planning of tibial plateau fracture reconstruction

Abstract 

Objective

Anatomical reconstruction of tibial plateau fractures is necessary to prevent pain, axial malalignment, knee join instability and posttraumatic arthritis. Computed tomography (CT) with 3D reconstruction is helpful in the accurate preoperative evaluation and reduction planning of the fracture site. The aim of this study was to describe the application of a virtual 3D reconstruction and segmentation software in the preoperative planning of tibial plateau fractures.

Patients and methods

CT scans of five tibial plateau fractures were preoperatively evaluated using the 3D planning software. Manual colour-coded segmentation was performed. The amount of time required for each planning session was recorded.

Results

Successful 3D reconstruction and segmentation was achieved in all cases. The mean time required for 3D virtual planning was 174.8min (range 69–124min). The mean time required for 3D virtual planning of B-type fractures was 96.5min (range 69–124min; SD=38.891min; CI=349.421). The mean time required for planning of C-type fractures was 227min (range 167–294min; SD=63.789min; CI=158.460) (Table 1).

Conclusion

Successful segmentation was achieved in all cases. The 3D planning capabilities of this software may be a valuable tool for surgeons in learning about the nature of the injury in tibial plateau fracture cases and in formulating an appropriate surgical plan. However, the time requirement for the 3D reconstruction and segmentation analysis may be a current deterrent for its use in the clinical setting.

Keywords: CAS, Tibial plateau fracture, Posttraumatic arthrosis, Malalignment, Computed tomography