[Translated article] Fracture planning is easy: Development of a basic method of digital planning based on the traditional pencil and paper technique

M Galán-Olleros; J García-Coiradas; S Llanos; J A Valle-Cruz; F Marco

doi:10.1016/j.recot.2022.07.002

[Translated article] Fracture planning is easy: Development of a basic method of digital planning based on the traditional pencil and paper technique

Rev Esp Cir Ortop Traumatol. 2022 Sep-Oct;66(5):T328-T340. doi: 10.1016/j.recot.2022.07.002. Epub 2022 Jul 14.

[Article in English, Spanish]

Authors

M Galán-Olleros¹, J García-Coiradas², S Llanos², J A Valle-Cruz², F Marco³

Affiliations

¹ Unidad de Traumatología y Politraumatizados, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario San Carlos, Madrid, Spain. Electronic address: mgalanolleros@gmail.com.
² Unidad de Traumatología y Politraumatizados, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario San Carlos, Madrid, Spain.
³ Unidad de Traumatología y Politraumatizados, Servicio de Traumatología y Cirugía Ortopédica, Hospital Clínico Universitario San Carlos, Madrid, Spain; Departamento de Cirugía, Facultad de Medicina de la Universidad Complutense de Madrid, Madrid, Spain.

PMID: 35843557
DOI: 10.1016/j.recot.2022.07.002

Abstract

Introduction: Preoperative planning constitutes a fundamental tool in the management of fractures; however, its practical application is far from the desired, perhaps due to the absence of a basic and simple method, adapted to the current times. We describe a digital planning method, halfway the traditional and the technological, which preserves its educational essence, allows for the understanding of the fracture and the individualisation of the osteosynthesis.

Material and methods: After the initial analysis of the fracture and the patient's characteristics, different measurements are made on X-ray and CT images with a digital medical imaging software. These images are then copied into a presentation programme (Microsoft® PowerPoint or Keynote ©Apple Inc.), in which the main fragments and fracture lines are traced with the computer pointer. These are subsequently moved into a reduced position and the implants for internal fixation are graphically represented together with a guide of the surgical strategy.

Results: We show 4 cases of different types of fractures operated through reduction and osteosynthesis after preoperative planning according to the described method. The basic points for the surgical planning, logistics, tactics and postoperative radiological results of each case are detailed.

Conclusions: Despite the rise of advanced planning software, traditional paper and pencil methods are still fundamental, even more so for the trauma surgeon in training. The digital planning method described is very appropriate for this purpose, as it combines the advantages of both methods: simplicity, accessibility, quickness, low cost, reproducibility, educational character, efficiency and possibility of simulation, corrections and reuse of cases.

Keywords: Computer software; Digital templating; Formación; Fracturas; Fracture; Planificación digital; Planificación preoperatoria; Preoperative planning; Programa informático; Reducción y osteosíntesis; Reduction and osteosynthesis; Training.