Use of 3D preoperative planning program in understanding of articular fracture treatment

Human joint is a complex 3D structure. When fractured, weight bearing articular surfaces of the joint have to be anatomically reduced and biomechanically stable coupled to the diaphysis with correct alignment of axis and rotation. To achieve this, soft tissue envelope should be traumatized as little as possible. We organized a course on preoperative planning of articular fractures with the use of computer 3D planning software, so surgeons could achieve the goal. 16 surgeons with different experiences of articular surgery, from residents to consultants, attended the course. First ordinary planning was done with 2D X-ray and CT images; later planning of the same cases was done with the use of 3D planning program. We compared chosen approach, reduction and use of implants in two fracture cases of knee joint. First was simple unicondylar and second complex bicondylar fracture of proximal tibia. Computer program used was EBS (Ekliptik, l.t.d.) In the simple case plan remained the same in 61,5 % participants. In more complex case participants changed their plan in 100%. 3D preoperative planning is essential for understanding and treating articular fractures. 3D preoperative program is useful as an educational and as a working tool.