title: [PRELIMINARY APPLICATION OF VIRTUAL PREOPERATIVE RECONSTRUCTION PLANNING IN Pilon FRACTURES].
abstract: OBJECTIVE
  To investigate the application value of three-dimensional reconstruction and virtual preoperative planning for Pilon fractures.
  
  
  METHODS
  Between July 2010 and June 2014, 16 patients with closed Pilon fracture were treated, including 12 males and 4 females with an average age of 36.5 years (range, 22-53 years) and a mean disease duration of 10.2 days (range, 6-14 days). According to AO/Orthopaedic Trauma Association (AO/OTA) typing, 2 cases were rated as 43.B2 type, 3 cases as 43.B3 type, 3 cases as 43.C1 type, 2 cases as 43.C2 type, and 6 cases as 43.C3 type. The preoperative CT data from 16 patients were imported into Mimics10.01 software to establish the detailed fracture three-dimensional digital models. Virtual operation of fracture reduction and implanting internal fixation was performed on the models, and the optional surgical planning was made. Based on the virtual preoperative planning, operations were performed.
  
  
  RESULTS
  Established detailed three-dimensional Pilon fracture digital models could perfectly reflect the fracture characteristics, could be observed at any direction, and aided for fracture classification accurately. Virtual fracture operations of reduction, internal fixation and other could be performed to simulate the clinical operation, which could assist the surgeon better preoperative planning in achieving visual presentation and improving the communication. The operation time was 70-130 minutes (mean, 87.8 minutes); intraoperative blood loss volume was 30-150 mL (mean, 71.9 mL). The wounds healed by first intension in all patients. The mean follow-up time was 11.6 months (range, 8-18 months). Postoperative radiological results at 3 groups showed good anatomic reduction according to the Burwell-Charnley criteria, and the fracture healing time was 3-6 months (mean, 3.7 months). There was no complication of internal fixation loosening or breakage during follow-up. The American Orthopedic Foot and Ankle Society (AOFAS) score was 71-100 (mean, 92.3); the results were excellent in 10 cases, good in 5 cases, and fair in 1 case, with an excellent and good rate of 93.8% at last follow-up. No loss of fracture reduction was observed on the X-ray film.
  
  
  CONCLUSIONS
  The clinical feasibility of virtual reconstruction preoperative planning is good in the treatment of Pilon fractures, which helps surgeons better understanding Pilon fracure and making the surgical planning.
authors.lastname: Wang Xiaoping
authors.forename: Zhantu
authors.initials: Z
authors.lastname: Wei
authors.forename: Jian
authors.initials: J
authors.lastname: Huang
authors.forename: Luyao
authors.initials: L
authors.lastname: Chen
authors.forename: Shiqiang
authors.initials: S
authors.lastname: Hu
authors.forename: Weiwei
authors.initials: W
authors.lastname: Wu
authors.forename: Yumin
authors.initials: Y
authors.lastname: Tu
authors.forename: Sheng
authors.initials: S
authors.lastname: Guo
authors.forename: Guotai
authors.initials: G
authors.lastname: Xu
authors.forename: Zhicheng
authors.initials: Z
authors.lastname: Deng
mesh_terms: D000328:Adult; D064386:Ankle Fractures; D016512:Ankle Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D005593:Fracture Fixation, Internal; D017102:Fracture Healing; D005596:Fractures, Closed; D005597:Fractures, Open; D006801:Humans; D015601:Injury Severity Score; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000379:methods*; D013978:Tibial Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome