Optimizing the 3D Plate Shape for Proximal Humerus Fractures

2023

Conference Paper

ps

To treat bone fractures, implant manufacturers produce 2D anatomically contoured plates. Unfortunately, existing plates only fit a limited segment of the population and/or require manual bending during surgery. Patient-specific implants would provide major benefits such as reducing surgery time and improving treatment outcomes but they are still rare in clinical practice. In this work, we propose a patient-specific design for the long helical 2D PHILOS (Proximal Humeral Internal Locking System) plate, used to treat humerus shaft fractures. Our method automatically creates a custom plate from a CT scan of a patient's bone. We start by designing an optimal plate on a template bone and, with an anatomy-aware registration method, we transfer this optimal design to any bone. In addition, for an arbitrary bone, our method assesses if a given plate is fit for surgery by automatically positioning it on the bone. We use this process to generate a compact set of plate shapes capable of fitting the bones within a given population. This plate set can be pre-printed in advance and readily available, removing the fabrication time between the fracture occurrence and the surgery. Extensive experiments on ex-vivo arms and 3D-printed bones show that the generated plate shapes (personalized and plate-set) faithfully match the individual bone anatomy and are suitable for clinical practice.

@conference{keller_humerusplate,
  title = {Optimizing the 3D Plate Shape for Proximal Humerus Fractures},
  author = {Keller, Marilyn and Krall, Marcell and Smith, James and Clement, Hans and Kerner, Alexander M. and Gradischar, Andreas and Sch{\"a}fer, Üte and Black, Michael J. and Weinberg, Annelie and Pujades, Sergi},
  booktitle = {International Conference on Medical Image Computing and Computer-Assisted Intervention (MICCAI)},
  pages = {487--496},
  publisher = {Springer},
  month = oct,
  year = {2023},
  doi = {10.1007/978-3-031-43990-2_46},
  month_numeric = {10}
}