3D modelling in preoperative planning in patients with tibial plateau fractures

Background. Preoperative planning is an important stage that allows you to determine intraoperative actions, helps to choose a rational approach, materials and implants necessary for reduction and fixation of fractures, to establish the amount of bone loss. The aim was to compare the effectiveness of X-ray, compu­ted tomography, and magnetic resonance imaging in diagnosing fractures of the proximal epimetaphysis of the tibia and to evaluate the effectiveness of using 3D technologies in surgical treatment. ­Material and methods. The clinical study was based on the exami­nation and treatment of 91 patients with fractures of the proximal epimetaphysis of the tibia from 2014 to 2024. To improve the qua­lity of preoperative planning, the Mimics program (from Materialise) was utilized. Results. Tibial plateau fractures were most common in working-age individuals aged 31 to 60 years (62.6 %). Іn intra-articular fractures of the proximal epimetaphysis of the tibia without displacement, the reliable diagnosis with computed tomography was 92.9 %, with X-ray examination — 57.1 % (p = 0.03), and in cases of displacement of fragments — 98.5 and 80.0 % (p = 0.002), respectively. The use of 3D modelling (study group) resulted in a reduction in operative time (102.4 vs. 126.2 minutes; p < 0.01) and a decrease in the frequency of intraoperative radiological control (3.2 vs. 5.2 times; p < 0.01). No statistically significant difference in the functional outcome of treatment was found. Conclusion. Computed tomography and magnetic resonance imaging are characterized by a sufficiently high informativeness in these fractures. 3D modelling allows for a 36.9 % reduction in the time of surgical intervention and a 61.5 % reduction in the frequency of intraoperative radiological control.