Research News The puzzle of a tibial plafond fracture

9 July 2024

In orthopaedic trauma there are many complex fractures of the boney parts of the body that need reduction to be functional again. Some fractures are scattered to the degree of a jigsaw puzzle. Hard to piece together, even harder to piece together without the example on the box.

Joy Verbakel and Miriam Boot, with help of others, researched if the use of 3D virtual planning can assist in the preoperative planning to achieve optimal fracture reduction in tibial plafond fractures. Under supervision of Erik Hermans, trauma surgeon at the Department of Trauma Surgery at Radboudumc, they researched whether the unfractured ankle might be used as the example on the box for hard to reduce fractures in the opposite ankle. The study results were published in the European Journal of Trauma and Emergency Surgery on the 14th of June 2024.

3D models were made with 75 bilateral CT-scans of unfractured distal tibia pairs, which were compared to see the left-right differences. The distal tibia pairs proved to have a high degree of bilateral symmetry. Meaning, the mirrored unfractured tibial plafond may be used as a template, to optimize preoperative surgical reduction using 3D virtual planning techniques, in patients with fractures of the distal tibia.

Not only is this outcome an asset to preoperative 3D virtual planning, it also helps determine the quality of postoperative reduction, by comparing the postoperative CT-scan and the CT-scan of the healthy tibial plafond. In future studies it may even be interesting to explore the possibilities of shaping 3D printed prosthetics of the tibial plafond in non-posttraumatic situations.

Read the study here:

Verbakel J, Boot MR, van der Gaast N, Dunning H, Bakker M, Jaarsma RL, Doornberg JN, Edwards MJR, van de Groes SAW, Hermans E. Symmetry of the left and right tibial plafond; a comparison of 75 distal tibia pairs. Eur J Trauma Emerg Surg. 2024 Jun 14. doi: 10.1007/s00068-024-02568-x. Epub ahead of print. PMID: 38874625.

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