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

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 t...

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Bibliographic Details
Published in:Revista española de cirugía ortopédica y traumatología 2022-09, Vol.66 (5), p.T328-T340
Main Authors: Galán-Olleros, M., García-Coiradas, J., Llanos, S., Valle-Cruz, J.A., Marco, F.
Format: Article
Language:eng ; spa
Subjects:
Computer software
Digital templating
Formación
Fracturas
Fracture
Planificación digital
Planificación preoperatoria
Preoperative planning
Programa informático
Reducción y osteosíntesis
Reduction and osteosynthesis
Training
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Summary: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. 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. 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. 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. La planificación preoperatoria constituye una herramienta fundamental en el manejo de fracturas; sin embargo, su aplicación práctica dista de lo deseado, quizá debido a la ausencia de un método básico y sencillo, adaptado a los tiempos actuales. Describimos un método de planificación digital, entre lo tradicional y lo tecnológico, que conserva su esencia educativa, permite comprender la fractura e individualizar la osteosíntesis. Tras el análisis inicial de la fractura y características del paciente, se realizan diferentes mediciones en las imágenes de Rx y TC con un software de imagen médica digital. Estas imágenes se copian en un programa de presentación (Microsoft® PowerPoint o Keynote ©Apple Inc.), en el que se reproducen con el puntero del ordenador los principales frag
ISSN:1888-4415
1988-8856
DOI:10.1016/j.recot.2022.07.002