A Computational/Experimental Platform for Investigating Three- Dimensional Puzzle Solving of Comminuted Articular Fractures

Date
2011-01-01
Authors
Thomas, Thaddeus
Anderson, Donald
Frank, Matthew
Willis, Andrew
Liu, Pengcheng
Frank, Matthew
Marsh, J. Lawrence
Brown, Thomas
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Abstract

Reconstructing highly comminuted articular fractures poses a difficult surgical challenge, akin to solving a complicated three-dimensional (3D) puzzle. Pre-operative planning using CT is critically important, given the desirability of less invasive surgical approaches. The goal of this work is to advance 3D puzzle solving methods toward use as a pre-operative tool for reconstructing these complex fractures. Methodology for generating typical fragmentation/dispersal patterns was developed. Five identical replicas of human distal tibia anatomy, were machined from blocks of high-density polyetherurethane foam (bone fragmentation surrogate), and were fractured using an instrumented drop tower. Pre- and post-fracture geometries were obtained using laser scans and CT. A semi-automatic virtual reconstruction computer program aligned fragment native (nonfracture) surfaces to a pre-fracture template. The tibias were precisely reconstructed with alignment accuracies ranging from 0.03-0.4mm. This novel technology has potential to significantly enhance surgical techniques for reconstructing comminuted intra-articular fractures, as illustrated for a representative clinical case.

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<p>This is a manuscript of an article from <em>Computer Methods in Biomechanics and Biomedical Engineering </em>14 (2011): 263, doi:<a href="http://dx.doi.org/10.1080/10255841003762042">10.1080/10255841003762042</a>. Posted with permission.</p>
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