ASB Clinical Biomechanics Award Paper 2010 Virtual pre-operative reconstruction planning for XXXX .

@entity174 @entity604 @entity9256 @entity85 @entity130
BACKGROUND: Highly comminuted intra-articular @entity174 are complex and @entity130 to treat. Once emergent care is rendered, the definitive treatment objective is to restore the original anatomy while minimizing surgically induced @entity130 . Operations that use limited or percutaneous approaches help preserve tissue vitality, but reduced visibility makes reconstruction more difficult. A pre-operative plan of how comminuted fragments would best be re-positioned to restore anatomy helps in executing a successful reduction. METHODS: In this study, the methods for virtually reconstructing a @entity174 were developed and applied to clinical cases. Building upon previous benchtop work, novel image analysis techniques and puzzle solving algorithms were developed for clinical application. Specialty image analysis tools were used to segment the @entity174 fragment geometries from CT data. The original anatomy was then restored by matching fragment native (periosteal and subchondral) bone surfaces to an intact template, generated from the uninjured contralateral limb. FINDINGS: Virtual reconstructions obtained for ten @entity174 cases had average alignment errors of 0.39 (0.5 standard deviation) mm. In addition to precise reduction planning, 3D puzzle solutions can help identify @entity85 and @entity604 . INTERPRETATION: The results from this study indicate that 3D puzzle solving provides a powerful new tool for planning the surgical reconstruction of @entity9256 .
