title: Novel computer-assisted preoperative planning system for humeral shaft fractures: report of 43 cases.
abstract: BACKGROUND
  Treatment for humeral shaft fractures is restoration of a painless shoulder and elbow with satisfactory function, but achieving good clinical outcomes for fracture healing is difficult, particularly in elderly patients. The aim of the study was to determine if computer-assisted preoperative planning (CAPP) improves clinical outcomes of humeral shaft fractures.
  
  
  METHODS
  In total, 43 patients were treated for humeral shaft fractures using locking plates with CAPP. The total time needed and total cost for fracture fragments' virtual segmentation/reduction/fixation were recorded. Intra- and inter-observer reliability was analyzed with intraclass correlation coefficients (ICCs). Clinical function was analyzed with Constant Score, Mayo Elbow Performance Score (MEPS), visual analogue scale (VAS) for pain, short-form health survey (SF-36), and radiology.
  
  
  RESULTS
  Mean total CAPP time for 12-A, 12-B, and 12-C fractures were 12.78±1.19, 22.07±1.12, and 38.56±2.11 min, respectively. Observer reliability was high (ICC 0.766-0.995). Mean operation time was 76.8±9.2 min. Follow-up (39/43 cases) averaged 36.5 months. Mean Constant Score and MEPS were 85.2±8.1 and 95.7±3.2, respectively. Average VAS was 1.3 points. Mean physical and mental component summary SF-36 scores were 74.3±5.1 and 76.9±5.9, respectively. Two patients had delayed union.
  
  
  CONCLUSIONS
  The novel CAPP system was efficient and reliable, providing excellent clinical outcomes for treatment of humeral shaft fractures using locking plates.
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Yanxi
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Minfei
authors.initials: M
authors.lastname: Qiang
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Kun
authors.initials: K
authors.lastname: Zhang
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Haobo
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Orthopaedic Trauma, East Hospital, Tongji University School of Medicine, Shanghai, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Dai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging* / Q000534:rehabilitation / Q000601:surgery*; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D015203:Reproducibility of Results; D025321:Surgery, Computer-Assisted / Q000379:methods*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014584:User-Computer Interface
keywords: 3D imaging; computer-aided design; humeral shaft fractures; preoperative planning