Enhancing Preoperative Planning in Orthopedic Trauma Surgery Using a Presentation Software<sup/>

Preoperative planning (PP) is critical to ensure a successful outcome in orthopaedic trauma surgery. Since it was first described thirty years ago, no modifications have been made to the original preoperative planning (OPP) technique, which was written by hand using pen and paper. We believe that the use of presentation software (such as Microsoft PowerPoint, Microsoft Corp., Redmond, WA, US) can ease, improve and update the OPP and complement three-dimensional PP. The objective of the present paper is to describe our method for PP using a presentation software (PS).

Keywords:
preoperative care; orthopedics; trauma; surgery; education

Authorship

Alejandro Ordas-Bayon

Department of Trauma and Orthopedic Surgery, Cambridge University Hospitals, Cambridge, United KingdomCambridge University HospitalsUnited KingdomCambridge, United KingdomDepartment of Trauma and Orthopedic Surgery, Cambridge University Hospitals, Cambridge, United Kingdom

https://orcid.org/0000-0002-9918-3753

David Cabrera Ortiz

Department of Trauma and Orthopedic Surgery, Universidad del Rosario, Bogotá, ColombiaUniversidad del RosarioColombiaBogotá, ColombiaDepartment of Trauma and Orthopedic Surgery, Universidad del Rosario, Bogotá, Colombia

https://orcid.org/0000-0003-4847-4929

Karl Logan

https://orcid.org/0000-0003-0270-7133

Rodrigo Pesantez

Departament of Orthopedics and Traumatology, Fundación Santa Fe de Bogotá, Bogotá, ColombiaDepartament of Orthopedics and TraumatologyColombiaBogotá, ColombiaDepartament of Orthopedics and Traumatology, Fundación Santa Fe de Bogotá, Bogotá, Colombia

https://orcid.org/0000-0002-5728-3115

*
Work developed at the Department of Trauma and Orthopedic Surgery, Fundación Santa Fe, Bogotá, Colombia.

Address for correspondence Alejandro Ordas Bayon, MD, Fellow of the European Board of Orthopedics and Traumatology (FEBOT), Department of Trauma and Orthopedic Surgery, Cambridge University Hospitals, Cambridge Biomedical Campus, Hills Road, CB2 0QQ, Cambridge, United Kingdom (e-mail: ordastrauma@gmail.com).

Conflict of Interests

The authors have no conflict of interests to declare.

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Figures | Tables

Figures (8)
Tables (1)

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Video 1
Introduction to the PPPS and reconstruction. Online content including video sequences viewable at: https://s20.video-stream-hosting.de/tvg/ejournal/10.1055-s-00042410/10-1055-s-0040-1721833-rbo-20-00126-v1_360p.mp4.

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Fig.1
Slide representing the layout of the operating theater. As it can be seen by the operating room personnel, it improves team communication and saves time. S = surgeon; A = assistant; N = nurse; AN = anesthesiologist; II screen = image intensifier screen.

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Fig. 2
Orthogonal views of a distal humerus fracture (A). The same images after applying the following commands: Picture Format > Artistic Effects > Glow Edges (B).

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Video 2
Fixation and equipment list. Online content including video sequences viewable at: https://s20.video-stream-hosting.de/tvg/ejournal/10.1055-s-00042410/10-1055-s-0040-1721833-rbo-20-00126-v2_360p.mp4

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Fig. 3
An anteroposterior view of the fracture is cropped and pasted as a separate image (A). Using Background Removal, the distal (B, C) and proximal fragments (D) are delimited. Both images are fitted in together to reconstruct the fracture (E).

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Fig. 4
A screenshot of the implant (medial distal humerus plate) from the operative technique is taken (A). The image is pasted onto a slide (B) and edited to have its background removed (C) and its color changed (D). The edited image is superimposed on the ruler to be accurately scaled, according to the implant’s size chart (E). The final image is adjusted to fit the reconstructed fracture (F).

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Fig. 5
Fixation stage of a 3.5-mm cortical screw in the preoperative planning with a presentation software. A screenshot from the surgical technique manual is cropped (A) and pasted on a slide to have its background removed (B). The color of the image is changed to blue and placed over a ruler to scale its diameter (C). The one-third tubular plate and the screws are shown over the reconstruction after applying the Transparency tool (D).

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Fig. 6
Key slides from the final result of the PPPS.

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Table 1
Presentation Layout for the preoperative planning with a presentation software

Video 1 Introduction to the PPPS and reconstruction. Online content including video sequences viewable at: https://s20.video-stream-hosting.de/tvg/ejournal/10.1055-s-00042410/10-1055-s-0040-1721833-rbo-20-00126-v1_360p.mp4.

Fig.1 Slide representing the layout of the operating theater. As it can be seen by the operating room personnel, it improves team communication and saves time. S = surgeon; A = assistant; N = nurse; AN = anesthesiologist; II screen = image intensifier screen.

Fig. 2 Orthogonal views of a distal humerus fracture (A). The same images after applying the following commands: Picture Format > Artistic Effects > Glow Edges (B).

Video 2 Fixation and equipment list. Online content including video sequences viewable at: https://s20.video-stream-hosting.de/tvg/ejournal/10.1055-s-00042410/10-1055-s-0040-1721833-rbo-20-00126-v2_360p.mp4

Fig. 3 An anteroposterior view of the fracture is cropped and pasted as a separate image (A). Using Background Removal, the distal (B, C) and proximal fragments (D) are delimited. Both images are fitted in together to reconstruct the fracture (E).

Fig. 4 A screenshot of the implant (medial distal humerus plate) from the operative technique is taken (A). The image is pasted onto a slide (B) and edited to have its background removed (C) and its color changed (D). The edited image is superimposed on the ruler to be accurately scaled, according to the implant’s size chart (E). The final image is adjusted to fit the reconstructed fracture (F).

Fig. 5 Fixation stage of a 3.5-mm cortical screw in the preoperative planning with a presentation software. A screenshot from the surgical technique manual is cropped (A) and pasted on a slide to have its background removed (B). The color of the image is changed to blue and placed over a ruler to scale its diameter (C). The one-third tubular plate and the screws are shown over the reconstruction after applying the Transparency tool (D).

Fig. 6 Key slides from the final result of the PPPS.

Table 1 Presentation Layout for the preoperative planning with a presentation software

- Title slide Keywords and date identifying the case

- Medical history Patient information and mechanism of injury

- Soft-tissue status Pictures of the involved area

- Layout of the operating theater Single slide showing staff and theater layout (►Fig. 1)

- Imaging

- Reconstruction

- Decision-making

- Fixation

- Surgical tactic

o Equipment

o Preparation

o Stepwise plan

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