期刊
ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH
卷 104, 期 3, 页码 359-362出版社
ELSEVIER MASSON, CORPORATION OFFICE
DOI: 10.1016/j.otsr.2018.01.007
关键词
Acetabular fracture; Biomechanical model; Virtual planning; Computer-assisted surgery; Segmentation
资金
- ANR France
- Fondation pour l'Avenir (labex CAMI) [ANR-11-LABX-0004]
Preoperative planning for the management of acetabular fracture is founded on geometric models allowing virtual repositioning of the bone fragments, but not taking account of soft tissue and the realities of the surgical procedure. The present technical note reports results using the first simulator to be based on a patient-specific biomechanical model, simulating the action of forces on the fragments and also the interactions between soft issue and bone: muscles, capsules, ligaments, and bone contacts. In all 14 cases, biomechanical simulation faithfully reproduced the intraoperative behavior of the various bone fragments and reduction quality. On Matta's criteria, anatomic reduction was achieved in 12 of the 14 patients (86%; 0.25 mm +/- 0.45 [range: 0-1]) and in the 12 corresponding simulations (86%; 0.42 mm +/- 0.51 [range: 0-1]). Mean semi-automatic segmentation time was 156 min +/- 37.9 [range: 120-180]. Mean simulation time was 23 min +/- 9 [range: 16-38]. The model needs larger-scale prospective validation, but offers a new tool suitable for teaching purposes and for assessment of surgical results in acetabular fracture. (C) 2018 Elsevier Masson SAS. All rights reserved.
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