PMC8546289_01
Left scapular fracture - 3D CT reconstruction.
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TraumaTech software. The program uses data from individual patients' CT scans (Figure 1) to create a 3D reconstruction of the fracture, including highlighting and color-coding the individual fragments of the fracture, and supports 3D printing of both the fractured bones and the implant.
Manual rough delineation of the fracture fragments.
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First, individual fragments were manually roughly outlined in the software (relatively accurately where the fragments were present in the bone and only very roughly where there was empty space around the fragment; Figure 2).
Manual reduction of the fragments.
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Subsequently, we assessed two methods of virtual fracture reduction: (I) manual virtual reduction of the fracture to the original anatomical shape or its nearest form (Figure 3) and (II) image mirroring offered by the software (using the paired bone, in this case, the other scapula, as a template for automatic remodeling; Figure 4).
Mirroring the image.
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Subsequently, we assessed two methods of virtual fracture reduction: (I) manual virtual reduction of the fracture to the original anatomical shape or its nearest form (Figure 3) and (II) image mirroring offered by the software (using the paired bone, in this case, the other scapula, as a template for automatic remodeling; Figure 4).
Scapular fracture after the reduction in the TraumaTech software, including optimizing of the implant shape (left) and modeling of the fixation screws (right).
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Subsequently, we virtually applied, resized, and reshaped the osteosynthesis implant to optimize it for the planned osteosynthesis (Figure 5a). Subsequently, individual fixation screws and their length were planned in the computer program (Figure 5b).
3D print of the scapula model and the implant.
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After that, the virtually reduced fractured scapula as well as the plate were 3D printed (Figure 6).
Osteosynthesis of the scapula using a pre-shaped implant.
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Subsequently, the plate was placed on the lateral edge, its proximal part penetrating the neck of the scapula and therefore fixating the crucial part of the scapular fracture (Figure 7).
Post-surgery X-ray.
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The post-surgery X-ray is shown in Figure 8.