Evaluation of the computer-assisted virtual surgical technology in preoperative planning for distal femoral fracture

Background: The application of computer-assisted virtual surgical technology in preoperative planning for distal femoral fractures has been rarely presented. This study aimed to evaluate the intra-operative realization of this technology and the clinical outcomes based on it for distal femoral fractures. Methods: Between February 2014 and May 2017, 32 patients with distal femoral fractures treated by open reduction and internal fixation were included and divided into 2 groups on the basis of preoperative planning methods: conventional (N= 17) and virtual surgical (N=15). The time required for virtual segmentation, reduction, and fixation of the fracture fragments in virtual surgical group were analyzed. Operation time, intra-operative blood loss, times of fluoroscopy during operation and days of hospital stay in two groups were compared. Postoperative functional outcomes were assessed using the Knee Society Score (KSS), Short Form-36 (SF-36) scoring systems, and visual analogue scale (VAS) for pain. Results: Mean total planning time for 33-A, 33-B, and 33-C fractures in virtual surgical group were 43.0 +/- 1.7, 23.0 +/- 1.3, and 51.4 +/- 3.7 min, respectively. Compared with the conventional group, Patients in virtual surgical group had lower blood loss, fewer fluoroscopic images, less operative time, and shorter days of hospital stay (P < 0.05). No significant difference could detected in the KSS, SF-36, or VAS scores between the two groups at the final follow-up (P > 0.05). Conclusions: Computer-assisted virtual surgical technology could rapidly complete surgical treatment protocol, improve operative efficiency, and provide satisfying clinical and radiographic outcomes for distal femoral fractures. (C) 2019 Elsevier Ltd. All rights reserved.