RESUMEN
Planning of a fracture reduction is important in order to reduce the surgery time, with the consequent improvement of the recovery process. There are no fully automatic methods that solve an adequate fracture reduction without the intervention of a specialist. Usually there are parameters that must be supervised or adjusted by the specialist, in order to obtain a satisfactory reduction. Furthermore, most of the studies in the literature focus on a certain type of bone and area on it. This paper presents an approach that tries to reduce to some extent the intervention of the specialist, so that it can be closer to an automatic approach. The proposed method can be applied to a wide variety of bones and areas, based on the identification of the complete fracture zone and the use of an ICP algorithm modified to work with the distance between fragments. The cases in which it has been tested are clinical cases of real fractures obtained from CT scan. This method allows working with a wide range of fractures, as well as complex fractures or deformed fragments. Unfortunately, all possible cases and situations could not be obtained and proved, but the method can be successfully applied to cases that meet a set of characteristics. The proposed technique has been validated by experts, both visually and empirically, using a framework based on virtual reality (VR). This VR framework has allowed comparing the reduction performed by the method with a reduction made virtually by specialists. This technique has also been compared with other existing techniques, obtaining a significant improvement over these.
Asunto(s)
Fijación Interna de Fracturas , Fracturas Óseas , Algoritmos , Fijación de Fractura , Fracturas Óseas/diagnóstico por imagen , Fracturas Óseas/cirugía , Humanos , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND AND OBJECTIVE: the acquisition of microscopic images of human bones is a complex and expensive process. Moreover, the objective of obtaining a large data bank with microscopic images in order to carry out massive studies or to train automatic generation algorithms is not an option. Consequently, most of the current work focuses on the analysis of small regions captured by a microscope. The aim is the development of a tool to represent bone tissue at microscopic levels which is suitable for performing physical simulations, as well as for the diagnosis of various diseases. This work includes the whole process from the digitization of a human bone to the generation of bone tissue in a determined area of the bone selected through a cutting plane. METHODS: based on the anatomy of the bone structure, the parameters that allow the representation of the bone tissue at mesoscale level have been analyzed. Although the models are randomly generated, they are based on statistical parameters. The model generator is based on the analysis of images of bone tissue and its parameters, performing a representation of each of its relevant structures in a way that fulfils these parameters. RESULTS: the tool is useful for the virtual generation of bone tissue that satisfies the main characteristics of the cortical bone. The models obtained have been favorably evaluated in two stages. In the first stage, a scientific group has examined a set of images, in which images of the models generated were mixed with images obtained through traditional methods. Then, the physical characteristics of the generated tissue have been compared with the morphology of the bone tissue. CONCLUSIONS: the model generator allows us to perform precise simulations in order to obtain realistic images with physical characteristics in accordance with reality. It is necessary to emphasize that even though the most relevant structures are included, the proposed model generator can be expanded to include new parameters or elements, so that it can be adapted to new needs. It could even break down randomness and parameterize it completely in order to allow the recreation of the tissue conditions of other studies.