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Patient-Specific Three-Dimensional Composite Bone Models for Teaching and Operation Planning

Matthews, Felix ; Messmer, Peter ; Raikov, Vladislav ; Wanner, Guido ; Jacob, Augustinus ; Regazzoni, Pietro ; Egli, Adrian

In: Journal of Digital Imaging, 2009, vol. 22, no. 5, p. 473-482

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    Title
    • Patient-Specific Three-Dimensional Composite Bone Models for Teaching and Operation Planning
    Author
    • Matthews, Felix. Brigham and Women's Hospital, Surgical Planning Laboratory, Harvard Medical School, 75 Francis Street, Room L1-050, 02115, Boston, MA, USA
    • Messmer, Peter. Center for Clinical Morphology and Biomedical Engineering, University of Basel, Computer Assisted Radiology and Computer Assisted Surgery (CARCAS), Basel, Switzerland
    • Raikov, Vladislav. Center for Clinical Morphology and Biomedical Engineering, University of Basel, Computer Assisted Radiology and Computer Assisted Surgery (CARCAS), Basel, Switzerland
    • Wanner, Guido. Center for Clinical Morphology and Biomedical Engineering, University of Basel, Computer Assisted Radiology and Computer Assisted Surgery (CARCAS), Basel, Switzerland
    • Jacob, Augustinus. Center for Clinical Morphology and Biomedical Engineering, University of Basel, Computer Assisted Radiology and Computer Assisted Surgery (CARCAS), Basel, Switzerland
    • Regazzoni, Pietro. Center for Clinical Morphology and Biomedical Engineering, University of Basel, Computer Assisted Radiology and Computer Assisted Surgery (CARCAS), Basel, Switzerland
    • Egli, Adrian. Center for Clinical Morphology and Biomedical Engineering, University of Basel, Computer Assisted Radiology and Computer Assisted Surgery (CARCAS), Basel, Switzerland
    Document Type
    • Postprint
    OAI-PMH Identifier
    • oai:doc.rero.ch:310201
    Summary
    Background: Orthopedic trauma care relies on two-dimensional radiograms both before and during the operation. Understanding the three-dimensional nature of complex fractures on plain radiograms is challenging. Modern fluoroscopes can acquire three-dimensional volume datasets even during an operation, but the device limitations constrain the acquired volume to a cube of only 12-cm edge. However, viewing the surrounding intact structures is important to comprehend the fracture in its context. We suggest merging a fluoroscope's volume scan into a generic bone model to form a composite full-length 3D bone model. Methods: Materials consisted of one cadaver bone and 20 three-dimensional surface models of human femora. Radiograms and computed tomography scans were taken before and after applying a controlled fracture to the bone. A 3D scan of the fracture was acquired using a mobile fluoroscope (Siemens Siremobil). The fracture was fitted into the generic bone models by rigid registration using a modified least-squares algorithm. Registration precision was determined and a clinical appraisal of the composite models obtained. Results: Twenty composite bone models were generated. Average registration precision was 2.0mm (range 1.6 to 2.6). Average processing time on a laptop computer was 35s (range 20 to 55). Comparing synthesized radiograms with the actual radiograms of the fractured bone yielded clinically satisfactory results. Conclusion: A three-dimensional full-length representation of a fractured bone can reliably be synthesized from a short scan of the patient's fracture and a generic bone model. This patient-specific model can subsequently be used for teaching, surgical operation planning, and intraoperative visualization purposes