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Virtual surgical preoperative planning more convenient, efficient vs 3-D planning
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Although virtual surgical and 3-D preoperative planning for treatment of three- and four-part proximal humeral fractures yielded better clinical outcomes compared with conventional planning, results published in Journal of Bone and Joint Surgery showed virtual surgical planning was more convenient and efficient.
Yanxi Chen, MD, PhD, and colleagues divided 131 patients with three- and four-part proximal humeral fractures to undergo conventional (n=53), virtual surgical (n=46) or 3-D printing (n=32) preoperative planning. Researchers evaluated fracture characteristics and intraoperative realization of preoperative planning. They also assessed postoperative functional outcomes using the American Shoulder and Elbow Surgeons, Constant-Murley and SF-36 scoring systems and shoulder range of motion, while they assessed postoperative radiographic outcomes with respect to the loss of the neck-shaft angle and loss of humeral head height.
Results showed all three groups had excellent sensitivity, specificity and accuracy for fracture characteristics. Researchers found patients in the virtual surgical group had higher correlations for neck-shaft angle and humeral head height compared with the 3-D printing group. Although the lengths of the medial support screws were longer in the preoperative plan for the 3-D printing group compared with the actual choices, researchers did not find a similar pattern in the virtual surgical group. Patients in the virtual surgical and 3-D printing methods of preoperative planning experienced shorter operative time, less blood loss and fewer fluoroscopic images as well as better functional outcomes vs. the conventional method, according to results. However, the virtual surgical method was faster with a shorter time to surgery, a shorter time for preoperative planning and a decreased duration of hospital stay compared with the 3-D printing method, researchers noted.
“We, as orthopedic trauma surgeons, need to be aware of the importance of preoperative planning in orthopedic surgery, especially for complex fractures. The results of this study indicated that the preoperative planning based on computer-assisted virtual surgical technology was efficient and convenient when compared with 3-dimensional printing technology,” Chen told Healio.com/Orthopedics. “In addition, patients who sustained fractures of the proximal humerus had relatively satisfactory clinical outcomes with the help of precise preoperative planning.”
Further, Chen noted the wide use of computer-assisted virtual surgery technology in the surgical treatment of systemic bone and joint injuries.
“As a result, the integration of cutting-edge computer technology and artificial intelligence into the medical field is an inevitable trend,” he said. “The development of computer-assisted orthopedics will promise the clinical research of orthopedics a new level.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.
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