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Preoperative Mixed-Reality Visualization of Complex Tibial Plateau Fractures and Its Benefit Compared to CT and 3D Printing

Background: Various studies have shown the benefit of three-dimensional (3D) computed tomography (CT) reconstruction and especially 3D printing in the treatment of tibial plateau fractures (TPFs). This study aimed to investigate whether mixed-reality visualization (MRV) using mixed-reality glasses c...

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Autores principales: Bitschi, David, Fürmetz, Julian, Gilbert, Fabian, Jörgens, Maximilian, Watrinet, Julius, Pätzold, Robert, Lang, Clemens, Neidlein, Claas, Böcker, Wolfgang, Bormann, Markus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10002526/
https://www.ncbi.nlm.nih.gov/pubmed/36902573
http://dx.doi.org/10.3390/jcm12051785
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author Bitschi, David
Fürmetz, Julian
Gilbert, Fabian
Jörgens, Maximilian
Watrinet, Julius
Pätzold, Robert
Lang, Clemens
Neidlein, Claas
Böcker, Wolfgang
Bormann, Markus
author_facet Bitschi, David
Fürmetz, Julian
Gilbert, Fabian
Jörgens, Maximilian
Watrinet, Julius
Pätzold, Robert
Lang, Clemens
Neidlein, Claas
Böcker, Wolfgang
Bormann, Markus
author_sort Bitschi, David
collection PubMed
description Background: Various studies have shown the benefit of three-dimensional (3D) computed tomography (CT) reconstruction and especially 3D printing in the treatment of tibial plateau fractures (TPFs). This study aimed to investigate whether mixed-reality visualization (MRV) using mixed-reality glasses can provide a benefit for CT and/or 3D printing in planning treatment strategies for complex TPFs. Methods: Three complex TPFs were selected for the study and processed for 3D imaging. Subsequently, the fractures were presented to specialists in trauma surgery using CT (including 3D CT reconstruction), MRV (hardware: Microsoft HoloLens 2; software: mediCAD MIXED REALITY) and 3D prints. A standardized questionnaire on fracture morphology and treatment strategy was completed after each imaging session. Results: 23 surgeons from 7 hospitals were interviewed. A total of 69.6% (n = 16) of those had treated at least 50 TPFs. A change in fracture classification according to Schatzker was recorded in 7.1% of the cases and in 78.6% an adjustment of the ten-segment classification was observed after MRV. In addition, the intended patient positioning changed in 16.1% of the cases, the surgical approach in 33.9% and osteosynthesis in 39.3%. A total of 82.1% of the participants rated MRV as beneficial compared to CT regarding fracture morphology and treatment planning. An additional benefit of 3D printing was reported in 57.1% of the cases (five-point Likert scale). Conclusions: Preoperative MRV of complex TPFs leads to improved fracture understanding, better treatment strategies and a higher detection rate of fractures in posterior segments, and it thus has the potential to improve patient care and outcomes.
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spelling pubmed-100025262023-03-11 Preoperative Mixed-Reality Visualization of Complex Tibial Plateau Fractures and Its Benefit Compared to CT and 3D Printing Bitschi, David Fürmetz, Julian Gilbert, Fabian Jörgens, Maximilian Watrinet, Julius Pätzold, Robert Lang, Clemens Neidlein, Claas Böcker, Wolfgang Bormann, Markus J Clin Med Article Background: Various studies have shown the benefit of three-dimensional (3D) computed tomography (CT) reconstruction and especially 3D printing in the treatment of tibial plateau fractures (TPFs). This study aimed to investigate whether mixed-reality visualization (MRV) using mixed-reality glasses can provide a benefit for CT and/or 3D printing in planning treatment strategies for complex TPFs. Methods: Three complex TPFs were selected for the study and processed for 3D imaging. Subsequently, the fractures were presented to specialists in trauma surgery using CT (including 3D CT reconstruction), MRV (hardware: Microsoft HoloLens 2; software: mediCAD MIXED REALITY) and 3D prints. A standardized questionnaire on fracture morphology and treatment strategy was completed after each imaging session. Results: 23 surgeons from 7 hospitals were interviewed. A total of 69.6% (n = 16) of those had treated at least 50 TPFs. A change in fracture classification according to Schatzker was recorded in 7.1% of the cases and in 78.6% an adjustment of the ten-segment classification was observed after MRV. In addition, the intended patient positioning changed in 16.1% of the cases, the surgical approach in 33.9% and osteosynthesis in 39.3%. A total of 82.1% of the participants rated MRV as beneficial compared to CT regarding fracture morphology and treatment planning. An additional benefit of 3D printing was reported in 57.1% of the cases (five-point Likert scale). Conclusions: Preoperative MRV of complex TPFs leads to improved fracture understanding, better treatment strategies and a higher detection rate of fractures in posterior segments, and it thus has the potential to improve patient care and outcomes. MDPI 2023-02-23 /pmc/articles/PMC10002526/ /pubmed/36902573 http://dx.doi.org/10.3390/jcm12051785 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Bitschi, David
Fürmetz, Julian
Gilbert, Fabian
Jörgens, Maximilian
Watrinet, Julius
Pätzold, Robert
Lang, Clemens
Neidlein, Claas
Böcker, Wolfgang
Bormann, Markus
Preoperative Mixed-Reality Visualization of Complex Tibial Plateau Fractures and Its Benefit Compared to CT and 3D Printing
title Preoperative Mixed-Reality Visualization of Complex Tibial Plateau Fractures and Its Benefit Compared to CT and 3D Printing
title_full Preoperative Mixed-Reality Visualization of Complex Tibial Plateau Fractures and Its Benefit Compared to CT and 3D Printing
title_fullStr Preoperative Mixed-Reality Visualization of Complex Tibial Plateau Fractures and Its Benefit Compared to CT and 3D Printing
title_full_unstemmed Preoperative Mixed-Reality Visualization of Complex Tibial Plateau Fractures and Its Benefit Compared to CT and 3D Printing
title_short Preoperative Mixed-Reality Visualization of Complex Tibial Plateau Fractures and Its Benefit Compared to CT and 3D Printing
title_sort preoperative mixed-reality visualization of complex tibial plateau fractures and its benefit compared to ct and 3d printing
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10002526/
https://www.ncbi.nlm.nih.gov/pubmed/36902573
http://dx.doi.org/10.3390/jcm12051785
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