Pub Date : 2024-06-18DOI: 10.1097/OI9.0000000000000336
C. M. C. Samarita, J. A. Coruña, J. M. Coruña
Supplemental Digital Content is Available in the Text. Abstract Background: Preoperative templating plays an important part in attaining successful surgical outcomes after fracture fixation. Traditionally, surgeons have performed this task with printed radiographs, tracing paper, and colored markers. Now that digital radiography is ubiquitous, and digital templating platforms are needed but are expensive and may not be available to all surgeons, especially those in low-income and middle-income countries. In this study, we evaluate an innovative and user-friendly method using a mobile app that may facilitate the use of digital templating for all surgeons worldwide. Methods: A study involving 2 groups of residents (N = 12) was conducted. Group A (n = 6) was assigned to do conventional templating; Group B (n = 6) was assigned to perform digital templating. Each group then switched to the other templating method and the process was repeated. Conventional templates were evaluated using the Arbeitsgemeinschaft für Osteosynthesefragen-Association for the Study of Internal Fixation (AO-ASIF) guidelines of template completeness. Digital templates were assessed using Image-Based Surgery Planning. Each subject in both groups completed templates for 3 injury patterns: AO 2R2A3/2U2C2, 32B2, and 43C2. Wilcoxon signed-rank and binomial tests (5% level of significance) were used for statistical analysis. Results: Template processing, fracture classification, and plan elaboration were comparable between the traditional and digital template groups, with good interobserver and intraobserver reproducibility using the Wilcoxon signed-ranks test (all |z values| below 1.96, all P-values > 0.05). There was no significant difference in the evaluation scores for either exercise, whether doing a traditional standard template or the digital template (P value > 0.05). Conclusions: This study shows that digital templating can achieve the same goals as conventional preoperative templating for fracture fixation. With the ubiquity of digital radiography, digital templating provides an opportunity to visualize fracture configurations and create an optimum preoperative plan for fracture reconstruction using an innovative and user-friendly platform.
文中提供了补充数字内容。摘要 背景：术前制模在骨折固定后获得成功的手术效果方面发挥着重要作用。传统上，外科医生使用打印的射线照片、描图纸和彩色记号笔来完成这项任务。现在，数字放射摄影技术已经普及，因此需要数字模板平台，但该平台价格昂贵，并非所有外科医生都能使用，尤其是中低收入国家的外科医生。在本研究中，我们评估了一种使用移动应用程序的创新且用户友好的方法，该方法可方便全球所有外科医生使用数字模板。方法：研究涉及两组住院医师（12 人）。A 组（6 人）被分配进行传统模板制作；B 组（6 人）被分配进行数字模板制作。然后每组切换到另一种模板制作方法，并重复该过程。传统模板采用Arbeitsgemeinschaft für Osteosynthesefragen-Association for the Study of Internal Fixation (AO-ASIF)的模板完整性指南进行评估。数字模板采用基于图像的手术规划进行评估。两组的每位受试者都完成了 3 种损伤模式的模板：AO 2R2A3/2U2C2、32B2 和 43C2。统计分析采用 Wilcoxon 符号秩检验和二项检验（显著性水平为 5%）。结果使用 Wilcoxon 符号秩检验（所有 |z 值均低于 1.96，所有 P 值均大于 0.05），传统模板组和数字模板组的模板处理、骨折分类和计划制定具有可比性，且观察者之间和观察者内部具有良好的重现性。无论是使用传统标准模板还是数字模板，两种练习的评估得分均无明显差异（P 值 > 0.05）。结论这项研究表明，数字化模板可以实现与传统术前模板相同的骨折固定目标。随着数字放射成像技术的普及，数字模板技术提供了一个可视化骨折构型的机会，并利用创新和用户友好的平台为骨折重建制定最佳术前计划。
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