Personalized medicine in upper extremity trauma with 3D technology Flashcards
Name the different 3D applications for optimal treatment of upper extremity trauma
- Primary fracture treatment
- Complications following fractures
1. Understanding morphological specifics fracture (pattern)
2. Aid in reconstruction fracture
3. Aid in correction posttraumatic deformity (malunion/nonunion)
How do 3D applications in upper extremity trauma influence efficacy of surgical and technical outcome?
potential improvement
- degree of joint movement after intervention
- decreased complications or secondary surgeries
- increase last of usage (reconstruction of own joint vs short last of artificial joint)
How do 3D applications in upper extremity trauma influence efficacy of functional outcome and PROMs (patient reported outcome)?
- clinical relevance still under discussion/ unknown –> minimal important change (MIC)
How do 3D applications in upper extremity trauma influence efficacy of cost effectiveness?
- further research mandatory
What are future possibilities for 3D applications in upper extremity trauma?
- increased usage of 3D
- preplanning done by surgeon themselves
- VR or AR –> no printed planning models needed anymore
- not only done at UMCs done –> smaller hospitals
What does CAS stand for?
CAS = Computer assistend surgery
What are the steps in the current 3D workflow in medicine?
- Image acquisition (CT, MRI)
- Image reconstruction
- Image processing
- Design and Reverse engineering
- Manufacturing
Image segmentation
- Defining region of interest
- Selecting this region by selection of “voxels”
- Translate this selection to a 3d model
- a method in which a digital image is broken down into various subgroups called Image segments –> helps reducing the complexity of the image - to make further processing or analysis of the image simpler
- Segmentation = assigning labels to pixels
What is a Voxel?
A 3D Pixel
What needs to be taken into account during Step 1: Image acquisition of the 3D workflow?
Scanner type
Scanner protocol
* Tube current
* Tube potential
* Pitch
* Cycle time
* Collimation
* Beam filtration
* Resolution
Considered during Step 2: Image reconstruction of the 3D workflow?
- Field of view
- Slice thickness
- Voxel size
- Reconstruction plane
- Interval
- Overlap
- Reconstruction kernel
- Reconstruction
algorithm
What needs to be taken into account during Step 3: Image processing of the 3D workflow?
- Segmentation method
- Parameters:
threshold(s), seed
regions etc. - Triangulation method
- Mesh reduction
What needs to be taken into account during Step 4: Design and reverse engineering of the 3D workflow?
- 3D reconstruction
- Aligning, mirroring models for correct
fragment placement - Modelling of patient
specific drill/sawguides - Digitalize surgical tools
used for procedure
What needs to be taken into account during Step 4: Design and reverse engineering of the 3D workflow?
- AM method
- Slice thickness
- Machine accuracy
- Material
- Post processing
How can 3D application aid for eg. malunion distal radius fracture?
General: How can 3D be used during surgical planning, surgery, better outcome?
- 3D digital reconstruction
- 3D print of reconstruction for pre- bending surgical plate.
- Design of patient specific drill/saw guides for surgical assistance
- Fitting mold for size adjustments of autograft
