Virtual reduction is crucial for successful and accurate reduction of pelvic fractures.Various methods have been proposed in this regard.However,not all of them are applicable to every pelvic fracture.Among these meth...Virtual reduction is crucial for successful and accurate reduction of pelvic fractures.Various methods have been proposed in this regard.However,not all of them are applicable to every pelvic fracture.Among these methods,the efficiency and accuracy of the method based on statistical shape models in clinical applications require further improvement.This study proposes a virtual reduction method for pelvic fractures that uses statistical shape models and partial surface data of a broken pelvis.Simulated fracture and clinical case experiments were conducted to validate the accuracy and effectiveness of the proposed method.The simulated fracture experiments yielded an average error of 1.57±0.39 mm and a maximum error of 12.82±3.54 mm.The virtual reduction procedure takes approximately 40 s.Based on three clinical case experiments,the proposed method achieves an acceptable level of accuracy compared with manual reduction by a surgeon.The proposed method offers the advantages of shorter virtual reduction times and satisfactory reduction accuracy.In the future,it will be integrated into the preoperative planning system for pelvic fracture reduction,thereby improving patient outcomes.展开更多
Background： The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty （TKA）.This study investigated a customized guide ...Background： The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty （TKA）.This study investigated a customized guide plate for osteotomy placement in TKAs with the aid of the statistical shape model technique using weight-bearing lower-extremity X-rays and computed tomography （CT） images of the knee.Methods： From October 2014 to June 2015, 42 patients who underwent a TKA in Guizhou Provincial People＆#39;s Hospital were divided into a guide plate group （GPG, 21 cases） and a traditional surgery group （TSG, 21 cases） using a random number table method.In the GPG group, a guide plate was designed and printed using preoperative three-dimensional measurements to plan and digitally simulate the operation.TSG cases were treated with the conventional method.Outcomes were obtained from the postoperative image examination and short-term follow-up.Results： Operative time was 49.0 ＆#177; 10.5 min for GPG, and 62.0 ＆#177; 9.7 min in TSG.The coronal femoral angle, coronal tibial angle, posterior tibial slope, and the angle between the posterior condylar osteotomy surface and the surgical transepicondylar axis were 89.2 ＆#177; 1.7＆#176;, 89.0 ＆#177; 1.1＆#176;, 6.6 ＆#177; 1.4＆#176;, and 0.9 ＆#177; 0.3＆#176; in GPG, and 86.7 ＆#177; 2.9＆#176;, 87.6 ＆#177; 2.1＆#176;, 8.9 ＆#177; 2.8＆#176;, and 1.7 ＆#177; 0.8＆#176; in TSG, respectively.The Hospital for Special Surgery scores 3 months after surgery were 83.7 ＆#177; 18.4 in GPG and 71.5 ＆#177; 15.2 in TSG.Statistically significant differences were found between GPG and TSG in all measurements.Conclusions： A customized guide plate to create an accurate osteotomy in TKAs may be created using lower-extremity X-ray and knee CT images.This allows for shorter operative times and better postoperative alignment than the traditional surgery.Application of the digital guide plate may also result in better short-term outcomes.展开更多
基金supported by the National Key Research and Development Program of China(2020YFB1313800)the Key Research and Development Program of Shandong Province,China(2022CXGC020510).
文摘Virtual reduction is crucial for successful and accurate reduction of pelvic fractures.Various methods have been proposed in this regard.However,not all of them are applicable to every pelvic fracture.Among these methods,the efficiency and accuracy of the method based on statistical shape models in clinical applications require further improvement.This study proposes a virtual reduction method for pelvic fractures that uses statistical shape models and partial surface data of a broken pelvis.Simulated fracture and clinical case experiments were conducted to validate the accuracy and effectiveness of the proposed method.The simulated fracture experiments yielded an average error of 1.57±0.39 mm and a maximum error of 12.82±3.54 mm.The virtual reduction procedure takes approximately 40 s.Based on three clinical case experiments,the proposed method achieves an acceptable level of accuracy compared with manual reduction by a surgeon.The proposed method offers the advantages of shorter virtual reduction times and satisfactory reduction accuracy.In the future,it will be integrated into the preoperative planning system for pelvic fracture reduction,thereby improving patient outcomes.
文摘Background： The conventional method cannot guarantee the precise osteotomies required for a perfect realignment and a better prognosis after total knee arthroplasty （TKA）.This study investigated a customized guide plate for osteotomy placement in TKAs with the aid of the statistical shape model technique using weight-bearing lower-extremity X-rays and computed tomography （CT） images of the knee.Methods： From October 2014 to June 2015, 42 patients who underwent a TKA in Guizhou Provincial People＆#39;s Hospital were divided into a guide plate group （GPG, 21 cases） and a traditional surgery group （TSG, 21 cases） using a random number table method.In the GPG group, a guide plate was designed and printed using preoperative three-dimensional measurements to plan and digitally simulate the operation.TSG cases were treated with the conventional method.Outcomes were obtained from the postoperative image examination and short-term follow-up.Results： Operative time was 49.0 ＆#177; 10.5 min for GPG, and 62.0 ＆#177; 9.7 min in TSG.The coronal femoral angle, coronal tibial angle, posterior tibial slope, and the angle between the posterior condylar osteotomy surface and the surgical transepicondylar axis were 89.2 ＆#177; 1.7＆#176;, 89.0 ＆#177; 1.1＆#176;, 6.6 ＆#177; 1.4＆#176;, and 0.9 ＆#177; 0.3＆#176; in GPG, and 86.7 ＆#177; 2.9＆#176;, 87.6 ＆#177; 2.1＆#176;, 8.9 ＆#177; 2.8＆#176;, and 1.7 ＆#177; 0.8＆#176; in TSG, respectively.The Hospital for Special Surgery scores 3 months after surgery were 83.7 ＆#177; 18.4 in GPG and 71.5 ＆#177; 15.2 in TSG.Statistically significant differences were found between GPG and TSG in all measurements.Conclusions： A customized guide plate to create an accurate osteotomy in TKAs may be created using lower-extremity X-ray and knee CT images.This allows for shorter operative times and better postoperative alignment than the traditional surgery.Application of the digital guide plate may also result in better short-term outcomes.
