Virtual 3D planning of acetabular fracture reduction

Displaced acetabular fractures are best treated with open reduction to achieve anatomic reduction and maximize the chance of a good functional outcome. Because of the anatomic complexity and often limited visualization, fracture reduction can be difficult. Virtual planning software can allow the surgeon to understand the fracture morphology and to rehearse reduction maneuvers. The purpose of this study was to determine the effect of a novel virtual fracture reduction module on time and accuracy of reduction. Four acetabular fracture patterns were created in synthetic pelves, which were implanted with fiducial markers and were registered with CT scan. Ten surgeons used virtual fracture reduction software or conventional 2D planning methods and immediately reduced the fractures blindly in a viscous gel medium. 3D imaging was again performed and the accuracy of reduction was assessed. The average malreduction was significantly improved following planning with the virtual software compared to the standard technique. The time taken for reduction was also significantly less for two of the four fracture patterns. Virtual software may be useful for visualizing and planning treatment of fractures of the acetabulum, potentially leading to more accurate and efficient reductions, and may also be an effective educational tool. © 2007 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 26:547–552, 2008