The role of virtual and augmented reality in orthopedic trauma surgery: From diagnosis to rehabilitation.

Background and Purpose. Hip dislocation combined with acetabular fracture remains a challenging condition for orthopedic surgeons. In this study, we utilized a computer-assisted simulation and three-dimensional (3D) printing technology to treat patients with hip dislocation combined with acetabular fracture. We hypothesized that the 3D printing-assisted method would shorten the internal fixation time and surgical time. Methods. We retrospectively reviewed 16 patients diagnosed with traumatic posterior dislocation of hip combined with acetabular fractures and treated with plate fixation from September 2013 to August 2017. Patients were divided into two groups: (1) traditional method and (2) 3D printing groups. In the traditional method group, the plates were contoured during the surgery, whereas in the 3D printing group, the patient’s pelvic computed tomography image was transformed to the 3D medical image software for processing preoperatively. The fracture reduction was simulated by the computer. Thereafter, the 1:1 scale 3D printing model was used to design the surgical plan and contour patient-specific plates preoperatively. Results. The internal fixation time was significantly shorter in the 3D printing group than in the traditional method group (-33 min, P<0.05). The mean operative time was shorter than that in the traditional method group (-43 min). However, blood loss and postoperative radiograph results were similar between the groups. The complication rate was lower in the 3D printing group (2/7) than in the traditional method group (5/9). Interpretation. Computer-assisted simulation with 3D printing technology is a more efficient method for treating hip dislocation combined with acetabular fractures.

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Surgical Treatment for Posterior Dislocation of Hip Combined with Acetabular Fractures Using Preoperative Virtual Simulation and Three-Dimensional Printing Model-Assisted Precontoured Plate Fixation Techniques

Virtual Reality (VR) in orthopedic surgery has significantly increased in popularity in the areas of preoperative planning, intraoperative usage, and for education and training; however, its utilization lags behind other surgical disciplines and industries. The use of VR in orthopedics is largely focused on education and is currently endorsed by North American and European training committees. The use of VR in shoulder and elbow surgery has varying levels of evidence, from I to IV, and typically involves educational randomized controlled trials. To date, however, the terms and definitions surrounding VR technology used in the literature are often redundant, confusing, or outdated. The purpose of this review, therefore, was to characterize previous uses of VR in shoulder and elbow surgery in preoperative, intraoperative, and educational domains including trauma and elective surgery. Secondary objectives were to provide recommendations for updated terminology of immersive VR (iVR) as well as provide a framework for standardized reporting of research surrounding iVR in shoulder and elbow surgery.

The evolution of virtual reality in shoulder and elbow surgery

https://www.zora.uzh.ch/id/eprint/142153/1/__int.balgrist.ch_Data%24_Home2_FrustaciD_System_Desktop_2017_Vlachopoulos_A_Scale_Space_Curvature_Matching_Algorithm_For_The_Reconstruction_Of_Complex_Proximal_Humeral_Fractures_MIA.pdf

A scale-space curvature matching algorithm for the reconstruction of complex proximal humeral fractures.

Identification of fracture zones and its application in automatic bone fracture reduction

Computer assisted preoperative planning of bone fracture reduction: Simulation techniques and new trends.

M-learning is gaining limelight in university education. However, its use is not widespread in the teaching of Physical Therapy. This discipline is mainly manual in nature but there are subject areas such as Electrotherapy in which the direct manipulation of an electronic device is required for a proper learning of the therapy procedures. This is only possible during laboratory classes; thus autonomous learning is restricted. A recurrent complaint of students is that they only can study the matter in a theoretical way (with textbooks or using notes taken during the sessions) while in contrast their practical skills are evaluated in the exams. This is because they do not have the expensive equipment used in Electrotherapy and the access to teaching devices is restricted to the laboratory hours. The main objective of this work is the development and implementation of a mobile application that simulates the manipulation of clinical devices used in Electrotherapy with the aim of improving learning in this subject area of Physical Therapy. The secondary objectives are: to assess the impact of the application (satisfaction from students and learning outcomes) and to analyze if the application could serve as a reliable method for evaluating students' knowledge of the electrotherapy techniques.

Development and implementation of a mobile application to improve university teaching of electrotherapy

In recent years, many computational techniques have been proposed to help specialists in the fracture reduction process. This field of research is open and faces important challenges due to its intrinsic high complexity. The reduction of a complex bone fracture requires identifying the bone fragments, to estimate their proper position and to select and place adequate fixation devices in order to stabilise the fracture. The development of computer-assisted techniques aids the planning and the execution of those tasks. In this paper, the possibilities of mobile and wearable devices in a fracture reduction process are introduced and discussed from a global perspective. Specifically, we have reviewed opportunities and challenges of mobile and wearable devices in the following stages of the treatment of a bone fracture: diagnosis, planning, training, aiding and rehabilitation. Regarding mobile devices, the focus is placed on the visualisation of medical data, the human–computer interaction-specific iss...

Mobile devices in the context of bone fracture reduction: challenges and opportunities

The simulation of realistic fracture cases on geometric models representing bone structures is almost an unexplored field of research. These fractured models have many applications in computer-assisted methods that support specialist in fracture reduction interventions. For instance, the generation of specific fracture patterns can provide uncommon cases for training simulators or even can be used to improve machine-learning applications. This paper focuses on the issues to be considered in the generation of fractures on geometric models that represent bone structures. The main recent contributions for fracturing geometric models are examined and the challenges in terms of the application of real bone fracture patterns on geometric models are presented. Moreover, different alternatives for the evaluation of the results obtained by the geometric fracture generation algorithms when applied to bone structures are showed. Finally, the potential applications of the virtual generation of specific bone fractures are described.

Issues on the Simulation of Geometric Fractures of Bone Models

The use of computer-assisted procedures before or during surgery provides orthopaedic specialists additional information that help them to reduce surgery time and to improve the understanding of the fracture peculiarities. In this context, the calculation of the fracture area is one of the main tasks in order to better comprehend the fracture. This paper presents the initial results of a method for the calculation of the contact zone between bone fragments by using a curvature-based approach. The method only considers cortical tissue, thus it is robust again the deformation or lack of trabecular tissue because of the fracture. In the case of simple fractures, the contact zone coincides with the entire fracture area. However, the calculation of the contact zone in complex fractures avoids calculating correspondences between fragments; hence the proposed method favours the use of puzzle solving methods in order to address the fracture reduction computation. Our proposal is able to overcome the initial limitations of curvature-based methods such as noise sensitivity, and shows a robust behaviour under circumstances of inexact segmentation or low precision. (see http://www.acm.org/about/class/class/2012) CCS Concepts •Computing methodologies → Shape modeling; Simulation types and techniques; Image processing;

Félix Paulano-Godino

Papers

Computer assisted preoperative planning of bone fracture reduction: Simulation techniques and new trends.

Development and implementation of a mobile application to improve university teaching of electrotherapy

Mobile devices in the context of bone fracture reduction: challenges and opportunities

Issues on the Simulation of Geometric Fractures of Bone Models

A Curvature-based Method for Identifying the Contact Zone Between Bone Fragments: First Steps