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Augmented reality patient-specific reconstruction plate design for pelvic and acetabular fracture surgery

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International Journal of Computer Assisted Radiology and Surgery Aims and scope Submit manuscript

Abstract

Purpose

The objective of this work is to develop a preoperative reconstruction plate design system for unilateral pelvic and acetabular fracture reduction and internal fixation surgery, using computer graphics and augmented reality (AR) techniques, in order to respect the patient-specific morphology and to reduce surgical invasiveness, as well as to simplify the surgical procedure.

Materials and methods

Our AR-aided implant design and contouring system is composed of two subsystems: a semi-automatic 3D virtual fracture reduction system to establish the patient-specific anatomical model and a preoperative templating system to create the virtual and real surgical implants. Preoperative 3D CT data are taken as input. The virtual fracture reduction system exploits the symmetric nature of the skeletal system to build a “repaired” pelvis model, on which reconstruction plates are planned interactively. A lightweight AR environment is set up to allow surgeons to match the actual implants to the digital ones intuitively. The effectiveness of this system is qualitatively demonstrated with 6 clinical cases. Its reliability was assessed based on the inter-observer reproducibility of the resulting virtual implants.

Results

The implants designed with the proposed system were successfully applied to all cases through minimally invasive surgeries. After the treatments, no further complications were reported. The inter-observer variability of the virtual implant geometry is 0.63 mm on average with a standard deviation of 0.49 mm. The time required for implant creation with our system is 10 min on average.

Conclusion

It is feasible to apply the proposed AR-aided design system for noninvasive implant contouring for unilateral fracture reduction and internal fixation surgery. It also enables a patient-specific surgical planning procedure with potentially improved efficiency.

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Author information

Authors and Affiliations

  1. State Key Laboratory of Virtual Reality Technology and Systems, Beihang University, Beijing, China

    Fangyang Shen & Yue Qi

  2. IADI, INSERM U947, Université de Lorraine, Nancy, France

    Bailiang Chen

  3. Pôle Imagerie, CHU de Nancy, Nancy, France

    Bailiang Chen

  4. State Key Laboratory of Trauma, Burns and Combined Injury, Trauma Center, Institute of Surgery Research, Daping Hospital, Third Military Medical University, Chongqing, 400042, China

    Qingshan Guo & Yue Shen

Authors
  1. Fangyang Shen
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  2. Bailiang Chen
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  3. Qingshan Guo
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  4. Yue Qi
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  5. Yue Shen
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Correspondence to Yue Shen.

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Shen, F., Chen, B., Guo, Q. et al. Augmented reality patient-specific reconstruction plate design for pelvic and acetabular fracture surgery. Int J CARS 8, 169–179 (2013). https://doi.org/10.1007/s11548-012-0775-5

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  • DOI: https://doi.org/10.1007/s11548-012-0775-5

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